Provider Demographics
NPI:1609195437
Name:BATALDEN, HEATHER DAWN (MA, LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:BATALDEN
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:DAWN
Other - Last Name:DANILOVICS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPCC, NCC
Mailing Address - Street 1:455 ESPLANADE AVE APT # 1
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044
Mailing Address - Country:US
Mailing Address - Phone:650-513-6290
Mailing Address - Fax:
Practice Address - Street 1:13 LODATO AVENUE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-8252
Practice Address - Country:US
Practice Address - Phone:650-513-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004862101YP2500X
CA112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional