Provider Demographics
NPI:1427033554
Name:AHUMADA, ALEJANDRO G (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:G
Last Name:AHUMADA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 2ND AVE UNIT 305
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6232
Mailing Address - Country:US
Mailing Address - Phone:915-256-1132
Mailing Address - Fax:
Practice Address - Street 1:5395 RUFFIN RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1338
Practice Address - Country:US
Practice Address - Phone:858-569-8959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2015-01-27
Deactivation Date:2006-06-16
Deactivation Code:
Reactivation Date:2009-09-22
Provider Licenses
StateLicense IDTaxonomies
CA2697231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist