Provider Demographics
NPI:1568641843
Name:RISO, DENA JOY
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:JOY
Last Name:RISO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ROSECRANS ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2695
Mailing Address - Country:US
Mailing Address - Phone:619-756-7848
Mailing Address - Fax:619-564-7056
Practice Address - Street 1:1310 ROSECRANS ST STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2695
Practice Address - Country:US
Practice Address - Phone:619-756-7848
Practice Address - Fax:619-564-7056
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2535231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter