Healthcare Provider Details

I. General information

NPI: 1447208665
Provider Name (Legal Business Name): HEATHER PRICE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 GREENLEY RD
SONORA CA
95370-5200
US

IV. Provider business mailing address

PO BOX 535
JAMESTOWN CA
95327-0535
US

V. Phone/Fax

Practice location:
  • Phone: 206-536-5000
  • Fax:
Mailing address:
  • Phone: 209-984-4820
  • Fax: 209-984-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number63127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: