Provider Demographics
NPI:1134414279
Name:TIJSSELING, HEIDI ANITA (DVM)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANITA
Last Name:TIJSSELING
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:DR
Other - First Name:HEIDI
Other - Middle Name:ANITA
Other - Last Name:TIJSSELING-VOTINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:205 POND VIEW LN
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-9417
Mailing Address - Country:US
Mailing Address - Phone:916-769-4690
Mailing Address - Fax:
Practice Address - Street 1:803 READING ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3216
Practice Address - Country:US
Practice Address - Phone:916-985-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16363174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian