Provider Demographics
NPI:1972366359
Name:FLORES, DEANNA BELLE (IHS)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:BELLE
Last Name:FLORES
Suffix:
Gender:F
Credentials:IHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 APPIAN WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2520
Mailing Address - Country:US
Mailing Address - Phone:510-724-4327
Mailing Address - Fax:
Practice Address - Street 1:2150 APPIAN WAY STE 104
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2520
Practice Address - Country:US
Practice Address - Phone:510-724-4327
Practice Address - Fax:510-283-5577
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA10098237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist