Provider Demographics
NPI:1902128861
Name:MUNDELL-NOEL, ANN MARIE (MA)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:MUNDELL-NOEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:CWIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24251 AVENIDA DE LA CARLOTA B-1
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-667-9818
Mailing Address - Fax:949-699-3321
Practice Address - Street 1:24251 AVENIDA DE LA CARLOTA B-1
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-667-9818
Practice Address - Fax:949-699-3321
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA1844237700000X
CAAU911237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist