Healthcare Provider Details

I. General information

NPI: 1265444582
Provider Name (Legal Business Name): HEATHER JEAN AUSTIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SAN JOSE ST STE 301
SALINAS CA
93901
US

IV. Provider business mailing address

212 SAN JOSE ST STE 301
SALINAS CA
93901-3928
US

V. Phone/Fax

Practice location:
  • Phone: 831-759-3289
  • Fax: 831-753-5188
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2194
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: