Provider Demographics
NPI:1023437019
Name:HENG, VANESA ROSE
Entity type:Individual
Prefix:
First Name:VANESA
Middle Name:ROSE
Last Name:HENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VAN
Other - Middle Name:THUY
Other - Last Name:DUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW#93724
Mailing Address - Street 1:637 BOARDWALK
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-4865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:637 BOARDWALK
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4865
Practice Address - Country:US
Practice Address - Phone:415-554-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA937241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical