Individual provider Active NPI

Heather Faulk

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
National Provider Identifier
1720958713
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1103 Issued in CA
Practice address
4301 X St
Sacramento, CA 95817-2214
Phone
(916) 734-7040
Fax
(916) 734-7040
NPI assigned
Nov 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 1103 CA Primary

Addresses

Primary practice location

4301 X St
Sacramento, CA 95817-2214

Mailing address

4301 X St
Sacramento, CA 95817-2214
Phone (916) 734-7040

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1103CAMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1720958713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "916-734-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "916-734-7040",
            "fax_number": "916-734-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "1103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.