Provider Demographics
NPI:1770800534
Name:DEBONO, HEATHER RENEE (ASW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:DEBONO
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 CONROY LN STE 500
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4153
Mailing Address - Country:US
Mailing Address - Phone:916-784-6487
Mailing Address - Fax:916-784-6480
Practice Address - Street 1:1130 CONROY LN STE 500
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4153
Practice Address - Country:US
Practice Address - Phone:916-784-6487
Practice Address - Fax:916-784-6480
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health