Provider Demographics
NPI:1902977259
Name:HECKER, CYNTHIA WHITE (ASW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:WHITE
Last Name:HECKER
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 1:205 PACIFICA AVE
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-2904
Mailing Address - Country:US
Mailing Address - Phone:925-980-6972
Mailing Address - Fax:
Practice Address - Street 1:205 PACIFICA AVE
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-2904
Practice Address - Country:US
Practice Address - Phone:925-980-6972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 186941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical