Provider Demographics
NPI:1841708674
Name:HEUN, DIANNA (APCC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:HEUN
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8910 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1104
Mailing Address - Country:US
Mailing Address - Phone:818-514-5144
Mailing Address - Fax:858-514-5195
Practice Address - Street 1:8910 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:818-514-5144
Practice Address - Fax:858-514-5195
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health