Healthcare Provider Details

I. General information

NPI: 1760527162
Provider Name (Legal Business Name): LISA MONARDI AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA JASCHKE

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SAN CLEMENTE DR STE D140
CORTE MADERA CA
94925
US

IV. Provider business mailing address

45 SAN CLEMENTE DR STE D140
CORTE MADERA CA
94925-1210
US

V. Phone/Fax

Practice location:
  • Phone: 415-927-1567
  • Fax: 415-329-1924
Mailing address:
  • Phone: 415-927-1567
  • Fax: 415-329-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberAU1719
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License NumberAU1719
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1719
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA3491
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1719
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAU1719
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: