Heather Lynn Gibson | La Mesa, CA • PECOS Search

Heather Lynn Gibson

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5480 Baltimore Dr, Suite 250, La Mesa, CA 91942-2020

(619) 733-6414 (858) 247-2405

PECOS Enrollment

Based on the most recent information from CMS, provider Heather Lynn Gibson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1295270080
Provider Type
Individual
Full Name
Gibson, Heather Lynn
Credential
M.A, LMFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/3/2017
Last Updated
1/3/2017

Contact Information

Practice Location

5480 Baltimore Dr, Suite 250, La Mesa, CA 91942-2020

Unlisted Fax

Mailing Location

8148 Genesee Ave Apt 88, San Diego, CA 92122-1467

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 97630 California