Healthcare Provider Details

I. General information

NPI: 1235840323
Provider Name (Legal Business Name): ALEXANDER WILLIAM HEUMANN OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31441 AVENIDA DE LA VIS
SAN JUAN CAPISTRANO CA
92675-2401
US

IV. Provider business mailing address

33121 SOUTHWIND CT
SAN JUAN CAPISTRANO CA
92675-4610
US

V. Phone/Fax

Practice location:
  • Phone: 949-312-7227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: