Provider Demographics
NPI:1053989541
Name:SIMON, HEIDI (ASW 101843)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:ASW 101843
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9375
Mailing Address - Country:US
Mailing Address - Phone:530-283-3330
Mailing Address - Fax:
Practice Address - Street 1:702-130 RICHMOND RD E
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-5029
Practice Address - Country:US
Practice Address - Phone:530-257-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical