Provider Demographics
NPI:1508437518
Name:SEKATOR, SAMANTHA BROOKE (AUD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BROOKE
Last Name:SEKATOR
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 1:2894 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5224
Mailing Address - Country:US
Mailing Address - Phone:408-553-6900
Mailing Address - Fax:
Practice Address - Street 1:2894 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5224
Practice Address - Country:US
Practice Address - Phone:408-553-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3605231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist