Heather Lynne Eisenhardt, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

34101 Farenholt Ave
San Diego, CA 92134-7000

Phone

(619) 992-6398

NPI assigned

Nov 29, 2011

Last updated

Dec 6, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1811264278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 STATE ROUTE 119 E",
            "city": "ANNA",
            "state": "OH",
            "postal_code": "453029705",
            "telephone_number": "619-992-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "619-992-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHARDT",
        "first_name": "HEATHER",
        "middle_name": "LYNNE",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Lee Eisenberg, MD
• Kimberly Eisenberg, MSW
• Lara B Eisenberg, MA, ED.M.
• Michelle Eisenberg, PT
• Steven G Eisenberg, D.O.
• Paula A. Eisenhart, M.D.
• Michael Eisenhauer
• Amy J Eisenhower-Omholt, LMFT
• Alexandra Eisenman
• Maria T Eisenmann, RN, BSN, PHN

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.