Individual
ANA R HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E MAIN ST, 117, BARSTOW, CA 92311-2361
(760) 255-1496
Mailing address
222 E MAIN ST, 117, BARSTOW, CA 92311-2361
(760) 255-1496
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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