Individual
LAIS AMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED HAD
Contact information
Practice address
88 N. SAN MATEO DR, SAN MATEO, CA 94070
(650) 342-9449
Mailing address
88 N SAN MATEO DR, SAN MATEO, CA 94401-2824
(650) 342-9449
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA7626
CA
Other
Enumeration date
12/14/2010
Last updated
05/22/2019
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