Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Heather Waddle

Individual provider Clinical Social Worker · NPI 1457763518

Heather Waddle is a Clinical Social Worker in Represa, California. Qualified in 2010, 16 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
16
Licensed in
CA
In the registry since
2014

Practice location Address checks out

100 Prison Rd
Represa, CA 95671-3000
Phone: (916) 985-8610
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 61475 (CA)

Record details

NPI number1457763518
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 23, 2014
Last updated in NPPESMay 4, 2022
Certification dateMay 4, 2022
Mailing addressPo Box 290002, Represa, CA 95671-0002

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Represa