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General NPI Number Information
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NPI Number | 1194666487
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Entity Type | Individual
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Provider Name | HEATHER SHORT
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 27811 GREENSPOT RD STE A
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City | HIGHLAND
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State | CA
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Zip | 92346-4361
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Country | US
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Telephone | 909-443-2584
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 718
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City | FOREST FALLS
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State | CA
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Zip | 92339-0718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State | CA
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