Provider Demographics
NPI:1083678825
Name:GEORGE, HEIDI KREAMER (PT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:KREAMER
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15192 WOODARD RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2741
Mailing Address - Country:US
Mailing Address - Phone:408-395-8851
Mailing Address - Fax:
Practice Address - Street 1:14675 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1816
Practice Address - Country:US
Practice Address - Phone:408-395-8851
Practice Address - Fax:408-395-8840
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist