Provider Demographics
NPI:1851774517
Name:PAUL, ADRIENNE (MA)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:ACKERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:787 MUNRAS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3128
Mailing Address - Country:US
Mailing Address - Phone:831-645-7900
Mailing Address - Fax:
Practice Address - Street 1:787 MUNRAS AVE STE 101
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3128
Practice Address - Country:US
Practice Address - Phone:831-645-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist