Provider Demographics
NPI:1245494103
Name:LUEVANO, HEATHER LYNN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:LUEVANO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 KEARNY VILA RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-279-1223
Mailing Address - Fax:619-516-4757
Practice Address - Street 1:2120 THIBODO RD STE 230
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7901
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:619-516-4757
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 42278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist