Healthcare Provider Details

I. General information

NPI: 1851804660
Provider Name (Legal Business Name): HEIDI LYNN JOHNSON SCHMIDT DC, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI LYNN JOHNSON-SCHMIDT DC, ATC, FDN-P

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44274 GEORGE CUSHMAN CT STE 208
TEMECULA CA
92592-5945
US

IV. Provider business mailing address

29235 LODEN CIR
MENIFEE CA
92584-7355
US

V. Phone/Fax

Practice location:
  • Phone: 951-501-4252
  • Fax:
Mailing address:
  • Phone: 951-442-0973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number36322
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: