Healthcare Provider Details

I. General information

NPI: 1619885142
Provider Name (Legal Business Name): SAN JOSE AUDIOLOGY, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2748 SAN PABLO AVE
BERKELEY CA
94702-2240
US

IV. Provider business mailing address

2748 SAN PABLO AVE
BERKELEY CA
94702-2240
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-0681
  • Fax:
Mailing address:
  • Phone: 510-841-0681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN LIPSCHUTZ
Title or Position: OWNER
Credential: M.S., F-AAA
Phone: 510-841-0681