Provider Demographics
NPI:1417976606
Name:CUNNANE, SANDRA (AUD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:CUNNANE
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 1:4011 PASEO GRANDE
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556
Mailing Address - Country:US
Mailing Address - Phone:925-200-3734
Mailing Address - Fax:925-283-4158
Practice Address - Street 1:2415 HIGH SCHOOL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1800
Practice Address - Country:US
Practice Address - Phone:925-676-8101
Practice Address - Fax:925-676-8420
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 334231H00000X
CAHA 3052237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter