Provider Demographics
NPI:1699805762
Name:SALINE, GERALD WAYNE (PHD CCC-A)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:WAYNE
Last Name:SALINE
Suffix:
Gender:M
Credentials:PHD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:#A-202
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-942-7221
Mailing Address - Fax:760-942-3097
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:#A-202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-942-7221
Practice Address - Fax:760-942-3097
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU8190231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ153692Medicare UPIN