Provider Demographics
NPI:1407185846
Name:PAUR, KERI LOUISE
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:LOUISE
Last Name:PAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 HONOLULU AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1853
Mailing Address - Country:US
Mailing Address - Phone:818-248-8648
Mailing Address - Fax:818-248-7928
Practice Address - Street 1:2409 HONOLULU AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1871
Practice Address - Country:US
Practice Address - Phone:818-248-8648
Practice Address - Fax:818-248-7928
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7513237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist