NPI 1003048620

Tina Lisa Heck, PAC

Practitioner Physician Assistant San Luis Obispo, CA

Practice location

Address: 77 Casa St STE 201, San Luis Obispo, CA 93405-5806
Phone: (805) 269-1500
Mailing address: 2050 S Blosser Rd, Santa Maria, CA 93458-7310

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA20461 (CA)

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Registry record

NPI: 1003048620
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Aug 2009
Record last updated: 11 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.