Provider Demographics
NPI:1154613545
Name:DUGUAY, JOEL DAVID (HIS)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:DAVID
Last Name:DUGUAY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 TRANCAS ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3040
Mailing Address - Country:US
Mailing Address - Phone:707-252-0990
Mailing Address - Fax:707-252-9077
Practice Address - Street 1:895 TRANCAS STREET
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3040
Practice Address - Country:US
Practice Address - Phone:707-252-0990
Practice Address - Fax:707-252-9077
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHS7333237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA7333OtherSPEECH-LANGUAGE AND PATHOLOGY, AUDIOLOGY AND HEARING AID DISPENSERS BOARD