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Organization
HEATHER J DALE LICENSED CLINICAL SOCIAL WORKER CORPORATION
Active
Organization
HEATHER J DALE LICENSED CLINICAL SOCIAL WORKER CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER J DALE LCSW (PRESIDENT)
(949) 278-2204
Entity
Organization
Contact information
Practice address
13300 GARDEN GROVE BLVD, GARDEN GROVE, CA 92843-2207
(949) 278-2204
Mailing address
3500 ROSEHEDGE DR, FULLERTON, CA 92835-1628
(949) 278-2204
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891137733
—
CA
Enumeration date
10/17/2018
Last updated
01/17/2019
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