Provider Demographics
NPI:1407568546
Name:HEATHERINGTON, MARIA E (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:E
Last Name:HEATHERINGTON
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 W BROOK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-4602
Mailing Address - Country:US
Mailing Address - Phone:949-258-7073
Mailing Address - Fax:
Practice Address - Street 1:5891 WARNER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-4657
Practice Address - Country:US
Practice Address - Phone:714-846-3544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19525171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist