Healthcare Provider Details

I. General information

NPI: 1760807705
Provider Name (Legal Business Name): SHEHLA AFRIDI GODBOLE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEHLA KHAN AFRIDI AUD

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E EL CAMINO REAL
MOUNTAIN VIEW CA
94040-2833
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 650-934-7900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 2960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: