Clark, Deborah Wilson

Clark, Deborah Wilson is an individual health care provider with primary practice located at 3555 Alameda De Las Pulgas Ste 1, Menlo Park CA 94025-6509. 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 / Hearing Instrument Specialist. Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter is her primary health care specialty. Clark, Deborah Wilson can be contacted via phone (650) 854-1980.

Contact Information

Primary practice address
3555 Alameda De Las Pulgas Ste 1 Menlo Park CA 94025-6509
Phone: (650) 854-1980
Fax: (650) 854-1987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X AU 1833 California
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HA 3829 California

Profile Details

NPI number 1801935424
LBN Legal business name Clark, Deborah Wilson
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated Oct 15th, 2010 - about 15 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 1801935424 NPPES
California MEDICAID GR0023741

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