Provider Demographics
NPI:1760606024
Name:SAEKAN, TALLEY
Entity Type:Individual
Prefix:
First Name:TALLEY
Middle Name:
Last Name:SAEKAN
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 1:74059 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4105
Mailing Address - Country:US
Mailing Address - Phone:760-272-9817
Mailing Address - Fax:
Practice Address - Street 1:82563 BARI LN
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-3123
Practice Address - Country:US
Practice Address - Phone:760-272-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3795237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist