Individual
MRS. PHYLLIS BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCA
Contact information
Practice address
511 3RD ST W, SONOMA, CA 95476-6501
(707) 938-3610
Mailing address
511 3RD ST W, SONOMA, CA 95476-6501
(707) 938-3611
(408) 356-1988
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU289
CA
237600000X
Audiologist-Hearing Aid Fitter
HA1018
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AU0002829
—
CA
Enumeration date
06/22/2006
Last updated
08/28/2020
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