Provider Demographics
NPI:1285845446
Name:JOHNSTON, HEIDI FRANCES (DC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:FRANCES
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:FRANCES
Other - Last Name:DANZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3944 MURPHY CANYON RD STE C200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4417
Mailing Address - Country:US
Mailing Address - Phone:858-571-0160
Mailing Address - Fax:858-571-0163
Practice Address - Street 1:3944 MURPHY CANYON RD STE C200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4417
Practice Address - Country:US
Practice Address - Phone:858-571-0160
Practice Address - Fax:858-571-0163
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA270014068Medicare UPIN