Provider Demographics
NPI:1972102358
Name:HEAVIRLAND, ALANA MODEL (MA)
Entity Type:Individual
Prefix:MRS
First Name:ALANA
Middle Name:MODEL
Last Name:HEAVIRLAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27281 LAS RAMBLAS STE 200
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8303
Mailing Address - Country:US
Mailing Address - Phone:949-328-3330
Mailing Address - Fax:
Practice Address - Street 1:27281 LAS RAMBLAS STE 200
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8303
Practice Address - Country:US
Practice Address - Phone:949-328-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-18
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty