Healthcare Provider Details

I. General information

NPI: 1114763596
Provider Name (Legal Business Name): ALIENOR RICHARDSON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 CAMINO DEL RIO S STE 220
SAN DIEGO CA
92108-3817
US

IV. Provider business mailing address

2815 CAMINO DEL RIO S STE 220
SAN DIEGO CA
92108-3817
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-6772
  • Fax:
Mailing address:
  • Phone: 858-279-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: