Provider Demographics
NPI:1932341930
Name:VAJDA, LETICIA
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:VAJDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 GARDENA CT
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4654
Mailing Address - Country:US
Mailing Address - Phone:760-623-8111
Mailing Address - Fax:760-487-1636
Practice Address - Street 1:3703 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4202
Practice Address - Country:US
Practice Address - Phone:760-623-8111
Practice Address - Fax:760-487-1636
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist