Provider Demographics
NPI:1679998249
Name:MAGUIRE, HEATHER (PSYD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5254
Mailing Address - Country:US
Mailing Address - Phone:959-354-2030
Mailing Address - Fax:
Practice Address - Street 1:27 POPLAR DR
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5254
Practice Address - Country:US
Practice Address - Phone:949-354-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-13813103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst