Provider Demographics
NPI: | 1013932557 |
---|---|
Name: | SOLOW, LAWRENCE J (PHD) |
Entity Type: | Individual |
Prefix: | MR |
First Name: | LAWRENCE |
Middle Name: | J |
Last Name: | SOLOW |
Suffix: | |
Gender: | M |
Credentials: | PHD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 920 PARK ROW |
Mailing Address - Street 2: | |
Mailing Address - City: | SALINAS |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93901-2407 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 831-422-4427 |
Mailing Address - Fax: | 831-758-2363 |
Practice Address - Street 1: | 920 PARK ROW |
Practice Address - Street 2: | |
Practice Address - City: | SALINAS |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93901-2407 |
Practice Address - Country: | US |
Practice Address - Phone: | 831-422-4427 |
Practice Address - Fax: | 831-758-2363 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-13 |
Last Update Date: | 2015-04-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | AU278 | 237600000X, 231H00000X |
CA | HA11470 | 231HA2500X, 235500000X, 2355A2700X, 2355S0801X, 235Z00000X, 237600000X, 237700000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | |
Not Answered | 231HA2500X | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Supplier |
Not Answered | 235500000X | Speech, Language and Hearing Service Providers | Specialist/Technologist | |
Not Answered | 2355A2700X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Audiology Assistant |
Not Answered | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
Not Answered | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | |
Not Answered | 237700000X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 1013932557 | Medicaid | |
CA | 1013932557 | Medicaid | |
CA | HA0011470 | Medicaid |