Healthcare Provider Details

I. General information

NPI: 1518450758
Provider Name (Legal Business Name): VANESSA HEFFINGTON MS, LMFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 08/15/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W ST APT 18
SACRAMENTO CA
95818-1452
US

IV. Provider business mailing address

5960 S LAND PARK DR # 796
SACRAMENTO CA
95822-3313
US

V. Phone/Fax

Practice location:
  • Phone: 916-241-3714
  • Fax:
Mailing address:
  • Phone: 916-241-3714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number92154
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: