Provider Demographics
NPI:1154488807
Name:LEVY, ADRIANE S (AUD, CCCA)
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:S
Last Name:LEVY
Suffix:
Gender:F
Credentials:AUD, CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13863 PUTNEY RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 CAMINO DEL RIO N STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1542
Practice Address - Country:US
Practice Address - Phone:619-297-0845
Practice Address - Fax:619-297-0841
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1296231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist