Provider Demographics
NPI:1962835991
Name:KENG, HEIDI (RN, NP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:KENG
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MATEO
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:716 BOUNTY DR
Mailing Address - Street 2:APT. 1608
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2698
Mailing Address - Country:US
Mailing Address - Phone:916-802-3367
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:112A
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA779507163W00000X
CA20413363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse