Healthcare Provider Details

I. General information

NPI: 1184386187
Provider Name (Legal Business Name): NELSON AUDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MARICOPA HWY STE I
OJAI CA
93023-3154
US

IV. Provider business mailing address

1320 MARICOPA HWY STE I
OJAI CA
93023-3154
US

V. Phone/Fax

Practice location:
  • Phone: 805-633-9063
  • Fax: 805-633-9068
Mailing address:
  • Phone: 805-633-9063
  • Fax: 805-633-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355A2700X
TaxonomyAudiology Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LANCE NELSON
Title or Position: AUDIOLOGIST
Credential: AUD
Phone: 818-406-6700