Provider Demographics
NPI:1417663071
Name:HEFLEY, ALICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:HEFLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S KRAEMER BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-6100
Mailing Address - Country:US
Mailing Address - Phone:949-415-4152
Mailing Address - Fax:
Practice Address - Street 1:101 S KRAEMER BLVD STE 125
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6100
Practice Address - Country:US
Practice Address - Phone:949-415-4152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33830103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist