Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Veronika Mae Heteniak, PA-C

Individual provider Physician Assistant · NPI 1629645635

Veronika Mae Heteniak, PA-C is a Physician Assistant in North Hollywood, California. Qualified in 2021, 5 years ago. Practices with Lakeside Medical Organization a Medical Group Inc, a 65-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12660 Riverside Dr Ste 225
North Hollywood, CA 91607-3469
Phone: (818) 755-0265
Fax: (818) 753-9074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1629645635
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 8, 2021
Last updated in NPPESDecember 15, 2021
Certification dateDecember 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Lakeside Medical Organization A Medical Group Inc — 65 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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