Provider Demographics
NPI:1477235976
Name:VINCELETTE, AMALIA (DOCTOR OF AUDIOLOGY)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:VINCELETTE
Suffix:
Gender:F
Credentials:DOCTOR OF AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NINTH STREET
Mailing Address - Street 2:
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933
Mailing Address - Country:US
Mailing Address - Phone:831-884-1032
Mailing Address - Fax:
Practice Address - Street 1:201 NINTH STREET
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933
Practice Address - Country:US
Practice Address - Phone:831-884-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist