Provider Demographics
NPI:1770764672
Name:HECHANOVA, GRACE Y (BSPSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:Y
Last Name:HECHANOVA
Suffix:
Gender:F
Credentials:BSPSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7518 BECKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2536
Mailing Address - Country:US
Mailing Address - Phone:818-921-7903
Mailing Address - Fax:
Practice Address - Street 1:225 N MARIPOSA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4509
Practice Address - Country:US
Practice Address - Phone:213-389-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health