Individual provider Active NPI

Andrea Lyn Heermance, D.C.

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1164532636
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29397 Issued in CA
Practice address
4128 W Commonwealth Ave
Suite 101
Fullerton, CA 92833-2565
Phone
(714) 525-0300
Fax
(714) 525-3536
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29397 CA Primary

Addresses

Primary practice location

4128 W Commonwealth Ave
Suite 101
Fullerton, CA 92833-2565

Mailing address

4128 W Commonwealth Ave
Suite 101
Fullerton, CA 92833-2565
Phone (714) 525-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29397CAMDChiropractor
29397CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Heermance Family Chiropractic, Inc. Chiropractor Past Accepting new patients
Joseph Kim Chiropractic & Acupuncture Clinic Inc. PastSince Jul 25, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1164532636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 W COMMONWEALTH AVE",
            "address_2": "SUITE 101",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332565",
            "telephone_number": "714-525-0300",
            "fax_number": "714-525-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 W COMMONWEALTH AVE",
            "address_2": "SUITE 101",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332565",
            "telephone_number": "714-525-0300",
            "fax_number": "714-525-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEERMANCE",
        "first_name": "ANDREA",
        "middle_name": "LYN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.