Provider Demographics
NPI:1134545940
Name:HELDT, EMILY WILSON (AUD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:WILSON
Last Name:HELDT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MICHELLE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5395 RUFFIN RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1338
Mailing Address - Country:US
Mailing Address - Phone:858-569-8959
Mailing Address - Fax:858-569-8957
Practice Address - Street 1:5395 RUFFIN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1338
Practice Address - Country:US
Practice Address - Phone:858-569-8959
Practice Address - Fax:858-569-8957
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2966231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist