Provider Demographics
NPI:1467332247
Name:HEATH, DAWN ELIZABETH (SCHOOL PSYCH CREDENT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:HEATH
Suffix:
Gender:F
Credentials:SCHOOL PSYCH CREDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16948 ALITA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-6211
Mailing Address - Country:US
Mailing Address - Phone:951-400-2466
Mailing Address - Fax:951-398-7721
Practice Address - Street 1:16948 ALITA DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-6211
Practice Address - Country:US
Practice Address - Phone:951-400-2466
Practice Address - Fax:951-398-7721
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM411411103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty