Provider Demographics
NPI:1265180681
Name:BURNEY, HEIDI (PSYD)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BURNEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26753 LITTLEPAGE LN
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-6790
Mailing Address - Country:US
Mailing Address - Phone:619-800-2353
Mailing Address - Fax:
Practice Address - Street 1:221 W CREST ST STE 205
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1736
Practice Address - Country:US
Practice Address - Phone:619-800-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34880103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical