Provider Demographics
NPI:1669521639
Name:FRITSCHEN, MARGARET R (MA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:FRITSCHEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:FRITSCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:9246 EASTSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-9310
Mailing Address - Country:US
Mailing Address - Phone:707-837-8932
Mailing Address - Fax:
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:SUITE 180
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-571-4159
Practice Address - Fax:707-571-4322
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1406231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist