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Individual

HEATHER COAKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1421 EDINGER AVE STE D, TUSTIN, CA 92780-6287
(714) 542-8999
Mailing address
4650 PEPPERWOOD AVE, LONG BEACH, CA 90808-1071
(562) 824-4353

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21078
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
471452631
PSYCHOLOGIST
CA
Enumeration date
06/29/2007
Last updated
11/30/2021
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