Provider Demographics
NPI:1881714004
Name:LINDSTROM, RONALD JOHN (H A DISPENSER)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:JOHN
Last Name:LINDSTROM
Suffix:
Gender:M
Credentials:H A DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ELM AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4546
Mailing Address - Country:US
Mailing Address - Phone:530-888-7215
Mailing Address - Fax:530-888-6148
Practice Address - Street 1:340 ELM AVE
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4546
Practice Address - Country:US
Practice Address - Phone:530-888-7215
Practice Address - Fax:530-888-6148
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2423237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist