Basic Information
| Provider Information | |||||||||
| NPI: | 1003294794 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HECKENLIVELY | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7501 MAY WAY | ||||||||
| Address2: | |||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945833709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258290779 | ||||||||
| FaxNumber: | 9258290779 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 LENNON LN | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945982419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259062268 | ||||||||
| FaxNumber: | 9259022255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2015 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7424 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.