Healthcare Provider Details

I. General information

NPI: 1023131778
Provider Name (Legal Business Name): DEBORAH HEUERMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-1400
  • Fax: 628-206-7501
Mailing address:
  • Phone: 628-206-1400
  • Fax: 628-206-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP13291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: