Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 703271 | CA |
NPI | 1033309190 |
---|---|
Provider Name | Sarah Ann Keil Heinonen |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90010-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 20/04/2017 |