Individual
DR. HEATHER JANE FORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
970 RESERVE DR STE 205, ROSEVILLE, CA 95678-1378
(916) 780-1070
Mailing address
970 RESERVE DR STE 205, ROSEVILLE, CA 95678-1378
(916) 780-1070
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP4542
MN
103TC0700X
Clinical Psychologist
Primary
PSY 21489
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104315
UCARE
MN
05
—
382155200
—
MN
01
—
422L8FO
BCBS OF MN
MN
01
—
921001042869
PREFERRED ONE
MN
01
—
HP49457
HEALTHPARTNERS
MN
Enumeration date
02/27/2007
Last updated
10/13/2009
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