Healthcare Provider Details

I. General information

NPI: 1124332457
Provider Name (Legal Business Name): MRS. HEATHER ADRIANA STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER ADRIANA YBARRA

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8825 AERO DR # 305
SAN DIEGO CA
92123-2200
US

IV. Provider business mailing address

8825 AERO DR # 305
SAN DIEGO CA
92123-2200
US

V. Phone/Fax

Practice location:
  • Phone: 858-571-1964
  • Fax: 858-571-1967
Mailing address:
  • Phone: 858-512-5144
  • Fax: 858-512-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: