Provider Demographics
NPI:1346316254
Name:ORTON, CLODAGH (MA)
Entity Type:Individual
Prefix:MS
First Name:CLODAGH
Middle Name:
Last Name:ORTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N KNOLL RD
Mailing Address - Street 2:STE 1
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1665
Mailing Address - Country:US
Mailing Address - Phone:415-383-6633
Mailing Address - Fax:415-383-6918
Practice Address - Street 1:7 N KNOLL RD
Practice Address - Street 2:STE 1
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1665
Practice Address - Country:US
Practice Address - Phone:415-383-6633
Practice Address - Fax:415-383-6918
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAALL240231H00000X
CAHA2245237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ14285ZMedicare ID - Type Unspecified