Provider Demographics
NPI:1831247600
Name:FAILLACE, KAREN MARIE (AUD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:FAILLACE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3590 CAMINO DEL RIO N STE 201
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:619-517-3233
Practice Address - Street 1:3590 CAMINO DEL RIO N STE 201
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:619-517-3233
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1383237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter