Healthcare Provider Details

I. General information

NPI: 1386790657
Provider Name (Legal Business Name): CATHERINE JEAN HEYMANN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SULLIVAN AVE RM 408
DALY CITY CA
94015-2224
US

IV. Provider business mailing address

3712 BRANSON DR
SAN MATEO CA
94403-2906
US

V. Phone/Fax

Practice location:
  • Phone: 650-994-9771
  • Fax: 650-994-0341
Mailing address:
  • Phone: 650-574-5176
  • Fax: 650-571-5090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: