Provider Demographics
NPI:1982035721
Name:SANDISON, HEATHER MALIA (ND)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MALIA
Last Name:SANDISON
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 1:2267 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1939
Mailing Address - Country:US
Mailing Address - Phone:808-342-6271
Mailing Address - Fax:
Practice Address - Street 1:5268 BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2080
Practice Address - Country:US
Practice Address - Phone:619-335-1786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND618175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath