Provider Demographics
NPI:1184790438
Name:WISKERCHEN, MAUREEN JULIA (MA)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:JULIA
Last Name:WISKERCHEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:JULIA
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:11325 FORESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2316
Mailing Address - Country:US
Mailing Address - Phone:858-693-3092
Mailing Address - Fax:
Practice Address - Street 1:7150 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111
Practice Address - Country:US
Practice Address - Phone:858-279-6771
Practice Address - Fax:858-279-7505
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 896231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist