Provider Demographics
NPI:1073544730
Name:LOGAN, JOAN (HAD)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:LOGAN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 STATE ST
Mailing Address - Street 2:#302
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2430
Mailing Address - Country:US
Mailing Address - Phone:805-563-9481
Mailing Address - Fax:805-563-1847
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:#302
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2430
Practice Address - Country:US
Practice Address - Phone:805-563-9481
Practice Address - Fax:805-563-1847
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2020237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist