Provider Demographics
NPI:1851804660
Name:JOHNSON SCHMIDT, HEIDI LYNN (DC, ATC)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:LYNN
Last Name:JOHNSON SCHMIDT
Suffix:
Gender:F
Credentials:DC, ATC
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:LYNN
Other - Last Name:JOHNSON-SCHMIDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, ATC
Mailing Address - Street 1:29235 LODEN CIR
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7355
Mailing Address - Country:US
Mailing Address - Phone:951-442-0973
Mailing Address - Fax:
Practice Address - Street 1:42265 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4843
Practice Address - Country:US
Practice Address - Phone:951-442-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
CA36322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer