Healthcare Provider Details

I. General information

NPI: 1073519955
Provider Name (Legal Business Name): DEBRA JOAN ABEL AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15525 POMERADO RD E-1
POWAY CA
92064-2435
US

IV. Provider business mailing address

15525 POMERADO RD E-1
POWAY CA
92064-2435
US

V. Phone/Fax

Practice location:
  • Phone: 858-618-1249
  • Fax: 858-618-1284
Mailing address:
  • Phone: 858-618-1249
  • Fax: 858-618-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 2412
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAU 2412
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberAU 2412
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA--00248
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA 7238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: