Provider Demographics
NPI:1568105187
Name:COYLE, LORETTA YVONNE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:YVONNE
Last Name:COYLE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 THORNWOOD DR STE 145
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1221
Mailing Address - Country:US
Mailing Address - Phone:408-281-7773
Mailing Address - Fax:
Practice Address - Street 1:5406 THORNWOOD DR STE 145
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1221
Practice Address - Country:US
Practice Address - Phone:408-281-7773
Practice Address - Fax:408-213-6655
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8744237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist