Healthcare Provider Details

I. General information

NPI: 1992498448
Provider Name (Legal Business Name): HEIDI PAREL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEIDI GRIFFEN

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 07/02/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14600 SHERMAN WAY STE 200
VAN NUYS CA
91405-5850
US

IV. Provider business mailing address

411 S VIRGIL AVE APT 120
LOS ANGELES CA
90020-1411
US

V. Phone/Fax

Practice location:
  • Phone: 818-374-6901
  • Fax:
Mailing address:
  • Phone: 231-930-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14186
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: