Healthcare Provider Details

I. General information

NPI: 1316391923
Provider Name (Legal Business Name): AUDIOLOGY ASSOCIATES HEARING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MARGARET LN SUITE D
GRASS VALLEY CA
95945-4207
US

IV. Provider business mailing address

101 MARGARET LN SUITE D
GRASS VALLEY CA
95945-4207
US

V. Phone/Fax

Practice location:
  • Phone: 530-272-2247
  • Fax: 530-272-4120
Mailing address:
  • Phone: 530-272-2247
  • Fax: 530-272-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: SOL J BARROS
Title or Position: PRESIDENT
Credential: MS
Phone: 530-272-2247