| Mark C Heffernan Phd A Psychological Corporation | |
|
47 Provence Way Rancho Mirage CA 92270-2727 | |
| (760) 328-2286 | |
| Not Available |
| Full Name | Mark C Heffernan Phd A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 47 Provence Way, Rancho Mirage, California |
| Authorized Official Name and Position | Mark C Heffernan (OWNER) |
| Authorized Official Contact | 7603282286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark C Heffernan Phd A Psychological Corporation Po Box 2128 Rancho Mirage CA 92270-1055 Ph: (760) 328-2286 | Mark C Heffernan Phd A Psychological Corporation 47 Provence Way Rancho Mirage CA 92270-2727 Ph: (760) 328-2286 |
| NPI Number | 1871664698 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 11/22/2017 |
| Medicare PECOS PAC ID | 5193813475 |
|---|---|
| Medicare Enrollment ID | O20071120000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871664698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY14471 (California) | Primary |
| Provider Name | Mark C Heffernan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366513178 PECOS PAC ID: 4183653223 Enrollment ID: I20050809000336 |
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