Provider Demographics
NPI:1659527620
Name:HEILEMANN, TAMMY FONG (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:FONG
Last Name:HEILEMANN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:SUM
Other - Last Name:FONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5901 E. 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90822
Mailing Address - Country:US
Mailing Address - Phone:562-826-8000
Mailing Address - Fax:
Practice Address - Street 1:5901 E. 7TH STREET
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical