Healthcare Provider Details

I. General information

NPI: 1366367864
Provider Name (Legal Business Name): HEAVEN FIGUEROA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MACKENAN DR
CARY NC
27511-6498
US

IV. Provider business mailing address

201 MACKENAN DR
CARY NC
27511-6498
US

V. Phone/Fax

Practice location:
  • Phone: 657-444-9002
  • Fax: 848-466-7896
Mailing address:
  • Phone: 657-444-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number000040084371
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: