Provider Demographics
NPI:1205994811
Name:ROCKWELL, ASTRIDA V
Entity type:Individual
Prefix:
First Name:ASTRIDA
Middle Name:V
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 W STOCKTON RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9702
Mailing Address - Country:US
Mailing Address - Phone:209-532-5208
Mailing Address - Fax:209-532-0271
Practice Address - Street 1:162 W STOCKTON RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9702
Practice Address - Country:US
Practice Address - Phone:209-532-5208
Practice Address - Fax:209-532-0271
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA26231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter