Provider Demographics
NPI:1558519371
Name:DI BARTOLOMEO, MAXINE GWEN (MA)
Entity Type:Individual
Prefix:MRS
First Name:MAXINE
Middle Name:GWEN
Last Name:DI BARTOLOMEO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 CASTILLO ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4346
Mailing Address - Country:US
Mailing Address - Phone:805-563-1111
Mailing Address - Fax:805-563-2277
Practice Address - Street 1:2420 CASTILLO ST
Practice Address - Street 2:SUITE #100
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4346
Practice Address - Country:US
Practice Address - Phone:805-563-1111
Practice Address - Fax:805-563-2277
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU47237600000X
CAHA2639237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist