Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A77033 | CA |
Y | 111NI0900X | Internist | A77033 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A77033 | CA |
NPI | 1386660462 |
---|---|
Provider Name | Heather Anne Harris |
First Address | Newark, CA 94560-1197 |
Second Address | Newark, CA 94560-1197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A77033 | MEDICAL LICENSE (01) | CA |