Healthcare Provider Details

I. General information

NPI: 1235084294
Provider Name (Legal Business Name): HEATHER LOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 SHOREHAM PL STE 175
SAN DIEGO CA
92122-5925
US

IV. Provider business mailing address

4832 DOLIVA DR
SAN DIEGO CA
92117-3210
US

V. Phone/Fax

Practice location:
  • Phone: 858-558-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER LOW
Title or Position: ACUPUNCTURIST
Credential: DTCM, LAC
Phone: 858-353-0603