Healthcare Provider Details

I. General information

NPI: 1578513156
Provider Name (Legal Business Name): JANA DENISI VERASFORZZA AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD ROOM #0229
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

11301 WILSHIRE BLVD (126)
LOS ANGELES CA
90073-1003
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3701
  • Fax: 310-268-7491
Mailing address:
  • Phone: 310-478-3711
  • Fax: 310-268-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU2230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: