Provider Demographics
NPI:1740629229
Name:KARAN, TINA MARIE (MNS, CCC-A)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:KARAN
Suffix:
Gender:F
Credentials:MNS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38362 CHESTNUT CIR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6229
Mailing Address - Country:US
Mailing Address - Phone:951-760-6787
Mailing Address - Fax:
Practice Address - Street 1:38362 CHESTNUT CIR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6229
Practice Address - Country:US
Practice Address - Phone:951-760-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1401237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter