Provider Demographics
NPI:1629311469
Name:WASHINGTON, HEATHER OLIVIA (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:OLIVIA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:OLIVIA
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 W 2ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410-3262
Mailing Address - Country:US
Mailing Address - Phone:888-854-1397
Mailing Address - Fax:714-709-4974
Practice Address - Street 1:5379 HAMNER AVE UNIT 801
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752-1042
Practice Address - Country:US
Practice Address - Phone:888-854-1397
Practice Address - Fax:714-709-4684
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine