Provider Demographics
NPI:1861858490
Name:HERITAGE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HERITAGE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:CULKIN
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-230-1094
Mailing Address - Street 1:27971 HEDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3785
Mailing Address - Country:US
Mailing Address - Phone:949-230-1094
Mailing Address - Fax:
Practice Address - Street 1:27405 PUERTA REAL STE 150
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6366
Practice Address - Country:US
Practice Address - Phone:949-230-1094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13522103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty