Provider Demographics
NPI:1356686752
Name:GILBERT, HEIDI SCHUSSMAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:SCHUSSMAN
Last Name:GILBERT
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 1:2349 LA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3166
Mailing Address - Country:US
Mailing Address - Phone:916-362-6537
Mailing Address - Fax:
Practice Address - Street 1:8336 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1906
Practice Address - Country:US
Practice Address - Phone:916-944-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist