Provider Demographics
NPI:1073934311
Name:HEALING INTEGRATIONS
Entity Type:Organization
Organization Name:HEALING INTEGRATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-851-8011
Mailing Address - Street 1:PO BOX 7493
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-7493
Mailing Address - Country:US
Mailing Address - Phone:714-851-8011
Mailing Address - Fax:888-979-8144
Practice Address - Street 1:170 E 17TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3701
Practice Address - Country:US
Practice Address - Phone:714-851-8011
Practice Address - Fax:888-979-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty