Provider Demographics
NPI:1316994205
Name:VON PINNON, PAMELA (EDD, CCC-A)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:VON PINNON
Suffix:
Gender:F
Credentials:EDD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 WINFIELD BLVD
Mailing Address - Street 2:#3
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2430
Mailing Address - Country:US
Mailing Address - Phone:408-365-5700
Mailing Address - Fax:408-365-5702
Practice Address - Street 1:1275 LINCOLN AVE
Practice Address - Street 2:#6B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-3049
Practice Address - Country:US
Practice Address - Phone:408-294-0644
Practice Address - Fax:408-294-0474
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 417231H00000X
CAHA 989237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78771ZMedicaid
CAHA 989OtherDISPENSING LICENSE #
CAAU 417OtherAUDIOLOGY LICENSE #
CAHA 989OtherDISPENSING LICENSE #