Provider Demographics
NPI:1588449383
Name:RAYMUNDO, JOSEPH BRYAN SENEDRIN (AUD)
Entity type:Individual
Prefix:
First Name:JOSEPH BRYAN
Middle Name:SENEDRIN
Last Name:RAYMUNDO
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 CAMBRIDGE HILLS CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2068
Mailing Address - Country:US
Mailing Address - Phone:775-762-7415
Mailing Address - Fax:
Practice Address - Street 1:8985 S PECOS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7162
Practice Address - Country:US
Practice Address - Phone:702-647-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14453709231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist