Healthcare Provider Details

I. General information

NPI: 1992674352
Provider Name (Legal Business Name): HEIDI KILLINGER LAC DACM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 HOTEL CIR S STE 275
SAN DIEGO CA
92108-3429
US

IV. Provider business mailing address

1545 HOTEL CIR S STE 275
SAN DIEGO CA
92108-3429
US

V. Phone/Fax

Practice location:
  • Phone: 815-922-7049
  • Fax:
Mailing address:
  • Phone: 815-922-7049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: