Provider Demographics
NPI:1376874529
Name:PERRO, JAMIE DIANE (AUDIOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:DIANE
Last Name:PERRO
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 OLIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3468
Mailing Address - Country:US
Mailing Address - Phone:707-426-4327
Mailing Address - Fax:707-426-5190
Practice Address - Street 1:1287 OLIVER RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3468
Practice Address - Country:US
Practice Address - Phone:707-426-4327
Practice Address - Fax:707-426-5190
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001330231H00000X
CAAU2789231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist