Provider Demographics
NPI:1639233844
Name:TAFT, LAVONNE JOYETTE
Entity Type:Individual
Prefix:
First Name:LAVONNE
Middle Name:JOYETTE
Last Name:TAFT
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 1:710 S BROADWAY STE 209
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5219
Mailing Address - Country:US
Mailing Address - Phone:925-295-4327
Mailing Address - Fax:925-295-5496
Practice Address - Street 1:710 S BROADWAY
Practice Address - Street 2:STE 209
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5294
Practice Address - Country:US
Practice Address - Phone:925-295-4327
Practice Address - Fax:925-295-5496
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU893237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter