Provider Demographics
NPI:1952509994
Name:HEFFRON, MARY CLAIRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CLAIRE
Last Name:HEFFRON
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:747 52ND ST
Mailing Address - Street 2:EARLY CHILDHOOD MENTAL HEALTH
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3407
Mailing Address - Fax:510-238-9764
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:EARLY CHILDHOOD MENTAL HEALTH
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3407
Practice Address - Fax:510-238-9764
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16058103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical