Tristen Heitz Haug, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15346 Issued in CA

Practice address

3803 S Bascom Ave
Suite 200
Campbell, CA 95008-7317

Phone

(408) 559-0988

Fax

(408) 369-4263

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tristen Heitz Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1043364441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 SOUTH BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "945454235",
            "telephone_number": "408-559-0988",
            "fax_number": "408-369-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "408-559-0988",
            "fax_number": "408-369-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUG",
        "first_name": "TRISTEN",
        "middle_name": "HEITZ",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISTEN",
            "last_name": "HEITZ",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lynnette M Harris, MA, LMFT
• Harsirat Gondara, DDS, Inc.
• Jake Hamilton Hart, DC
• Nadeem Stewart Hasan, PSYD
• Yukie Hasebe, IBCLC
• Amelia Hausauer, M.D.
• Philip J Haworth, PT
• He Lian Tang Acupuncture, Inc.
• Hai He
• Lingmin He, M.D.

• Physician Assistant in Campbell, CA
• Providers in Campbell, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.