Provider Demographics
NPI:1366741878
Name:HEIMER, EMILY ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:HEIMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 FENTON ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4100
Mailing Address - Country:US
Mailing Address - Phone:925-373-9394
Mailing Address - Fax:925-373-2876
Practice Address - Street 1:87 FENTON ST
Practice Address - Street 2:SUITE 106
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4100
Practice Address - Country:US
Practice Address - Phone:925-373-9394
Practice Address - Fax:925-373-2876
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19456225100000X
CA42744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist