Provider Demographics
NPI:1548400054
Name:SALAMAT, MIMI T (PHD, CCC-A, FAAA)
Entity Type:Individual
Prefix:DR
First Name:MIMI
Middle Name:T
Last Name:SALAMAT
Suffix:
Gender:F
Credentials:PHD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BOULEVARD WAY
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1107
Mailing Address - Country:US
Mailing Address - Phone:925-937-4455
Mailing Address - Fax:
Practice Address - Street 1:1200 BOULEVARD WAY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-1107
Practice Address - Country:US
Practice Address - Phone:925-937-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 258L, HA 7388237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter