Provider Demographics
NPI:1164045001
Name:PENARANDA, REBECCA (AUD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PENARANDA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 S QUEEN ANNE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-3023
Mailing Address - Country:US
Mailing Address - Phone:267-709-8527
Mailing Address - Fax:
Practice Address - Street 1:1245 HIGHLAND AVE STE 502
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3726
Practice Address - Country:US
Practice Address - Phone:215-886-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist