Healthcare Provider Details

I. General information

NPI: 1265304331
Provider Name (Legal Business Name): ABIGAIL Z HEFFLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE BLDG A10 SUITE 10100
ALHAMBRA CA
91803-8800
US

IV. Provider business mailing address

3604 W ESTATES LN UNIT 318
ROLLING HILLS ESTATES CA
90274-4175
US

V. Phone/Fax

Practice location:
  • Phone: 626-349-3838
  • Fax: 855-838-9042
Mailing address:
  • Phone: 310-818-1583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: