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General NPI Number Information
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NPI Number | 1457418345
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Entity Type | Individual
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Provider Name | DENNIS ALDO COLUCCI AU.D., M.A., ABA
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 24672 SAN JUAN AVE STE 104
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City | DANA POINT
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State | CA
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Zip | 92629-2837
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Country | US
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Telephone | 949-230-1976
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Fax | 949-388-0932
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Provider Business Mailing Address
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Address Line | 32565 GOLDEN LANTERN ST SUITE B#117
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City | DANA POINT
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State | CA
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Zip | 92629-3261
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Country | US
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Telephone | 949-230-1976
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Fax | 949-388-0932
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU348
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License Number State | CA
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