Healthcare Provider Details

I. General information

NPI: 1679530661
Provider Name (Legal Business Name): LYNN A. KRIKORIAN MA, FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE
FRESNO CA
93703-2223
US

IV. Provider business mailing address

4159 W ALLUVIAL AVE
FRESNO CA
93722-9710
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-4100
  • Fax:
Mailing address:
  • Phone: 559-435-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU2046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: