Provider Demographics
NPI:1639809734
Name:HEREDIA, FRANCISCA
Entity Type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:
Last Name:HEREDIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 FREEBOARD DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5039
Mailing Address - Country:US
Mailing Address - Phone:530-351-7975
Mailing Address - Fax:530-351-7976
Practice Address - Street 1:3120 FREEBOARD DR STE 102
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-5039
Practice Address - Country:US
Practice Address - Phone:530-351-7975
Practice Address - Fax:530-351-7976
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health