Provider Demographics
NPI:1295778116
Name:HORNER, HEATHER A (AUD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:HORNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:BROFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8066-68 LA MESA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-644-9515
Mailing Address - Fax:
Practice Address - Street 1:8066-68 LA MESA BOULEVARD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-644-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2036231H00000X
CAHA4134237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist