Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MAKENZIE ALYCE HEISDORF, DPT
ActivePhysical Therapy Assistant · SAN CLEMENTE, CA
Registration Details
- NPI Number
- 1104861327
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 19, 2006 (19.866140509342 yrs)
- Last Updated
- Dec 14, 2020
- License
-
PT27882 (CA)
Practice Information
- Address
-
653 CAMINO DE LOS MARES STE 110SAN CLEMENTE, CA, 926732808Browse CA providers · Browse ZIP 92673
- Phone
- 9494960122
- Fax
- 9494965027
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in SAN CLEMENTE, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. NYSA R WILLIAMS | PT | 1861462061 |
| MR. DAVID WILLIAM REENDERS | RPT | 1245295146 |
| MAREN TANGE GEORGE | PT | 1881650679 |
| MRS. KRISTIN MASSAMIRI | MPT, ATC | 1932140068 |
| MRS. LISBETH ANNE GANNINGER | P.T. | 1801825898 |
| CHRISSIE MORGAN | P.T. | 1760490056 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.