Provider Demographics
NPI:1659856748
Name:SWEENEY, HEATHER M (CMT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:PALLEIKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:1507 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1619
Mailing Address - Country:US
Mailing Address - Phone:310-948-0723
Mailing Address - Fax:
Practice Address - Street 1:2701 OCEAN PARK BLVD STE 111
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5200
Practice Address - Country:US
Practice Address - Phone:424-410-9377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33675225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist