Provider Demographics
NPI:1972106250
Name:MATEER, ALAN (HAD)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:MATEER
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 CAYENTE WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-2937
Mailing Address - Country:US
Mailing Address - Phone:208-412-7979
Mailing Address - Fax:
Practice Address - Street 1:1260 FULTON AVE STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7396
Practice Address - Country:US
Practice Address - Phone:916-483-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8244237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist