Provider Demographics
NPI:1497820013
Name:BROOKS, VICKI LYNN (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LYNN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18095 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2189
Mailing Address - Country:US
Mailing Address - Phone:760-245-1653
Mailing Address - Fax:760-245-1654
Practice Address - Street 1:18095 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2189
Practice Address - Country:US
Practice Address - Phone:760-245-1653
Practice Address - Fax:760-245-1654
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3451237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist