Provider Demographics
NPI:1508889007
Name:PERKINS, MACCAIA D
Entity Type:Individual
Prefix:MRS
First Name:MACCAIA
Middle Name:D
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FILE # 55745
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0001
Mailing Address - Country:US
Mailing Address - Phone:323-549-0567
Mailing Address - Fax:323-549-0577
Practice Address - Street 1:8995 APOLLO WAY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4031
Practice Address - Country:US
Practice Address - Phone:562-804-3119
Practice Address - Fax:562-804-1882
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 4186237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist