Healthcare Provider Details

I. General information

NPI: 1215876560
Provider Name (Legal Business Name): JULIETTE DAVIS VAN HEERDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE UCSF DEPARTMENT OF SURGERY, S321
SAN FRANCISCO CA
94143
US

IV. Provider business mailing address

513 PARNASSUS AVE UCSF DEPARTMENT OF SURGERY, S321
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: