Provider Demographics
NPI:1093529414
Name:HELLER, ALLISON JADE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JADE
Last Name:HELLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9175 3RD AVE APT 143
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-3656
Mailing Address - Country:US
Mailing Address - Phone:760-508-6375
Mailing Address - Fax:
Practice Address - Street 1:1151 DOVE ST STE 150
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2837
Practice Address - Country:US
Practice Address - Phone:949-250-9194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst