Burt, Phyllis

Burt, Phyllis is an individual health care provider with primary practice located at 511 3Rd St W , Sonoma CA 95476-6501. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Burt, Phyllis can be contacted via phone (707) 938-3610.

Contact Information

Primary practice address
511 3Rd St W Sonoma CA 95476-6501
Phone: (707) 938-3610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X HA1018 California
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AU289 California

Profile Details

NPI number 1003852336
LBN Legal business name Burt, Phyllis
Credentials MA CCCA
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Aug 28th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003852336 NPPES
California MEDICAID AU0002829

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