Provider Demographics
NPI:1265955793
Name:KEARNEY, LUCIA (AUD)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LUCIA
Other - Last Name:KEARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3590 CAMINO DEL RIO N
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1707
Mailing Address - Country:US
Mailing Address - Phone:619-810-1204
Mailing Address - Fax:
Practice Address - Street 1:3590 CAMINO DEL RIO N
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1707
Practice Address - Country:US
Practice Address - Phone:619-810-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3210231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner