Healthcare Provider Details

I. General information

NPI: 1558795302
Provider Name (Legal Business Name): ESTHER K HEFETS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11838 PASO ROBLES AVE
GRANADA HILLS CA
91344-2561
US

IV. Provider business mailing address

11838 PASO ROBLES AVE
GRANADA HILLS CA
91344-2561
US

V. Phone/Fax

Practice location:
  • Phone: 818-832-8222
  • Fax:
Mailing address:
  • Phone: 818-832-8222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT22227
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1229357
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: