Provider Demographics
NPI:1255391694
Name:HECKER, EMILY BRIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BRIE
Last Name:HECKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:BRIE
Other - Last Name:VOORHEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 62106
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-2106
Mailing Address - Country:US
Mailing Address - Phone:805-681-1761
Mailing Address - Fax:805-681-1768
Practice Address - Street 1:2027 VILLAGE LN STE 102
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2271
Practice Address - Country:US
Practice Address - Phone:805-681-1761
Practice Address - Fax:805-681-1768
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA22663OtherSTATE LICENSE