Provider Demographics
NPI:1073175899
Name:HEYDON, ANITA SUMAN
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:SUMAN
Last Name:HEYDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:SUMAN
Other - Last Name:MCGIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7800 CLAYPOOL WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2707
Mailing Address - Country:US
Mailing Address - Phone:916-200-8447
Mailing Address - Fax:
Practice Address - Street 1:7800 CLAYPOOL WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2707
Practice Address - Country:US
Practice Address - Phone:916-200-8447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility