Provider Demographics
NPI:1518975804
Name:JEFFCOAT, HEATHER MICHELE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MICHELE
Last Name:JEFFCOAT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13425 VENTURA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3997
Mailing Address - Country:US
Mailing Address - Phone:818-877-6910
Mailing Address - Fax:818-647-0363
Practice Address - Street 1:13425 VENTURA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3997
Practice Address - Country:US
Practice Address - Phone:818-877-6910
Practice Address - Fax:818-647-0363
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29666225100000X
CA296662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP81362Medicare UPIN
CAWPT29666BMedicare ID - Type Unspecified