Healthcare Provider Details

I. General information

NPI: 1215396668
Provider Name (Legal Business Name): CATHERINE HEGGIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2016
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 N GILBERT ST
HEMET CA
92543-4013
US

IV. Provider business mailing address

235 N GILBERT ST
HEMET CA
92543-4013
US

V. Phone/Fax

Practice location:
  • Phone: 951-658-9000
  • Fax: 951-658-9585
Mailing address:
  • Phone: 951-658-9000
  • Fax: 951-658-9585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60645868
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT294702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: