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Individual

KENT E WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUD

Contact information

Practice address
26726 CROWN VALLEY PKWY, #210, MISSION VIEJO, CA 92691-8006
(959) 364-4361
(949) 364-7124
Mailing address
26726 CROWN VALLEY PKWY, #210, MISSION VIEJO, CA 92691-8006
(959) 364-4361
(949) 364-7124

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
00461
IA
231H00000X
Audiologist
Primary
AU3093
CA
237600000X
Audiologist-Hearing Aid Fitter
00744
IA
237600000X
Audiologist-Hearing Aid Fitter
AU3093
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0262824
IA
Enumeration date
03/07/2007
Last updated
10/24/2018
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