Healthcare Provider Details

I. General information

NPI: 1689805632
Provider Name (Legal Business Name): NORTH STATE AUDIOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 JAN CT
CHICO CA
95928-4418
US

IV. Provider business mailing address

15 JAN CT
CHICO CA
95928-4418
US

V. Phone/Fax

Practice location:
  • Phone: 530-899-3277
  • Fax: 530-895-0811
Mailing address:
  • Phone: 530-899-3277
  • Fax: 530-895-0811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberAU776
License Number StateCA

VIII. Authorized Official

Name: DR. CRYSTAL LYNN CHALMERS
Title or Position: OWNER/PROVIDER/CHAIRMAN OF THE BOAR
Credential: AU.D.
Phone: 530-899-3277