Provider Demographics
NPI:1235576133
Name:HELLER, ASHLEY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:HELLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:PARDOEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:235 VIA SAN ANDREAS
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3712
Mailing Address - Country:US
Mailing Address - Phone:949-498-0599
Mailing Address - Fax:
Practice Address - Street 1:235 VIA SAN ANDREAS
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3712
Practice Address - Country:US
Practice Address - Phone:949-498-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist