Provider Demographics
NPI:1184973950
Name:NAVARRO, HEATHER (LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:J
Other - Last Name:TOWNDROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:17031 TOKATA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1191
Mailing Address - Country:US
Mailing Address - Phone:385-243-1744
Mailing Address - Fax:
Practice Address - Street 1:17031 TOKATA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1191
Practice Address - Country:US
Practice Address - Phone:385-243-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
8309794-3502104100000X
CO099293901041C0700X
UT8309794-35011041C0700X
CA1228881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000087377Medicare UPIN