Provider Demographics
NPI:1669548814
Name:THOMAS, ALICE ANN (HEARING AID DISPENSE)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:A
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEARING AID DISPENSE
Mailing Address - Street 1:43797 15TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4755
Mailing Address - Country:US
Mailing Address - Phone:661-948-4776
Mailing Address - Fax:661-948-8163
Practice Address - Street 1:43797 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4755
Practice Address - Country:US
Practice Address - Phone:661-948-4776
Practice Address - Fax:661-948-8163
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2445237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0024451OtherMEDICAL STATE OF CALIFORNIA
CAHA2445OtherCALIFORNIA LICENSED HEARING AID DISPENSER