Provider Demographics
NPI:1225477938
Name:COLLORD JOHNSON, CLAIRE C (AUD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:C
Last Name:COLLORD JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:C
Other - Last Name:COLLORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2510 E SUNSET RD
Mailing Address - Street 2:UNIT 5-260
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3511
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:7090 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1596
Practice Address - Country:US
Practice Address - Phone:619-463-4327
Practice Address - Fax:619-589-1864
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2899237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter