Provider Demographics
NPI:1437724796
Name:BRANSTETTER, HEATHER (ND)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:BRANSTETTER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S WINCHESTER BLVD APT 3400
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2972
Mailing Address - Country:US
Mailing Address - Phone:360-824-0070
Mailing Address - Fax:
Practice Address - Street 1:1080 N 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4425
Practice Address - Country:US
Practice Address - Phone:408-869-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1171175F00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No175F00000XOther Service ProvidersNaturopath