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

Individual provider Case Manager/Care Coordinator · NPI 1003519323

Kelly Lorene Heimdahl is a Case Manager/Care Coordinator in Azusa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
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Practice location Address checks out

23701 E East Fork Rd
Azusa, CA 91702-1477
Phone: (626) 250-3290
Fax: (626) 910-1380
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X (CA)

Record details

NPI number1003519323
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 24, 2023
Last updated in NPPESMarch 24, 2023
Certification dateMarch 24, 2023

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