Provider Demographics
NPI:1730395286
Name:LOOMOS, DIMITRA (AUD, CCC-A, FAAA)
Entity type:Individual
Prefix:DR
First Name:DIMITRA
Middle Name:
Last Name:LOOMOS
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CAMINO RAMON STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2000
Mailing Address - Country:US
Mailing Address - Phone:510-282-7803
Mailing Address - Fax:
Practice Address - Street 1:2301 CAMINO RAMON STE 106
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-2000
Practice Address - Country:US
Practice Address - Phone:510-282-7803
Practice Address - Fax:925-901-0199
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU571 HA2110231HA2400X
CAHA2110237600000X
CAAU571231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter