Basic Information
| Provider Information | |||||||||
| NPI: | 1467548131 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEITKAMP | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | MORGEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25435 VIA ADORNA | ||||||||
| Address2: | |||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913552909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612843780 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25050 PEACHLAND AVE | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | NEWHALL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913212523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612222800 | ||||||||
| FaxNumber: | 6612553428 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A052668 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.