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General NPI Number Information
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NPI Number | 1538448881
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Entity Type | Individual
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Provider Name | LINDA KAY VASSALLO M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 100 S ELLSWORTH AVE STE 711
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City | SAN MATEO
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State | CA
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Zip | 94401-3927
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Country | US
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Telephone | 650-579-4470
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Fax | 650-579-4471
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Provider Business Mailing Address
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Address Line | 1101 BRICKELL AVE STE N1700
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City | MIAMI
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State | FL
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Zip | 33131-3105
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Country | US
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Telephone | 248-808-5463
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Fax | 650-579-4471
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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 | 1601000582
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3196
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License Number State | CA
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