Provider Demographics
NPI:1295048064
Name:HEYDEN, LAURA A (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:A
Last Name:HEYDEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 LARKIN ST
Mailing Address - Street 2:APT 3
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2357
Mailing Address - Country:US
Mailing Address - Phone:619-948-7817
Mailing Address - Fax:
Practice Address - Street 1:700 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2815
Practice Address - Country:US
Practice Address - Phone:831-645-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist