Healthcare Provider Details

I. General information

NPI: 1205780392
Provider Name (Legal Business Name): MEESHA HEYDON OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 LOMBARD ST APT 936
SAN FRANCISCO CA
94111-1163
US

IV. Provider business mailing address

240 LOMBARD ST APT 936
SAN FRANCISCO CA
94111-1163
US

V. Phone/Fax

Practice location:
  • Phone: 707-293-7998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number26583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: