Provider Demographics
NPI:1740543255
Name:KUERBIS, TRACY LYNN (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYNN
Last Name:KUERBIS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39350 GALLAUDET DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2308
Mailing Address - Country:US
Mailing Address - Phone:510-794-3703
Mailing Address - Fax:
Practice Address - Street 1:39350 GALLAUDET DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2308
Practice Address - Country:US
Practice Address - Phone:510-794-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1427231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist