Provider Demographics
NPI:1194049379
Name:LOOPER, LOUIS ARLEN (MA)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:ARLEN
Last Name:LOOPER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:LOOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:795 MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5193
Mailing Address - Country:US
Mailing Address - Phone:209-588-0662
Mailing Address - Fax:209-588-0664
Practice Address - Street 1:795 MORNING STAR DR
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5193
Practice Address - Country:US
Practice Address - Phone:209-588-0662
Practice Address - Fax:209-588-0664
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2066237600000X
CAHA4076237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter