MEDICARE: JUDY HANSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231HA2400X	Assistive Technology Practitioner Audiologist

General Provider Information

NPI Number	:	1568584365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY HANSON

Provider Business Mailing Address
First Line	:	1111 EXPOSITION BLVD STE 700
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4300
Country	:	US
Telephone Number	:	916-736-3408
Fax Number	:	916-233-4171

Provider Business Practice Location Address
First Line	:	1111 EXPOSITION BLVD STE 700
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4300
Country	:	US
Telephone Number	:	916-736-3408
Fax Number	:	916-233-4171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	10/07/2008

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Directions to “ JUDY HANSON ” Practice Location

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