Provider Demographics
NPI:1841405412
Name:ALLEN, HEIDI SAISIMUA KISHOYIAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:SAISIMUA KISHOYIAN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 29TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1119
Mailing Address - Country:US
Mailing Address - Phone:916-203-7427
Mailing Address - Fax:916-967-7958
Practice Address - Street 1:2020 29TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1119
Practice Address - Country:US
Practice Address - Phone:916-203-7427
Practice Address - Fax:916-967-7958
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical