Provider Demographics
NPI:1962781260
Name:TOWNSEND, KEVIN C (MA)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:C
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 LA PLATA AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6217
Mailing Address - Country:US
Mailing Address - Phone:626-277-3698
Mailing Address - Fax:626-269-0690
Practice Address - Street 1:8241 ROCHESTER AVE
Practice Address - Street 2:STE 130
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0700
Practice Address - Country:US
Practice Address - Phone:626-363-4725
Practice Address - Fax:626-269-0690
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2780231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist