Healthcare Provider Details

I. General information

NPI: 1609602572
Provider Name (Legal Business Name): FAYEMARIE HERMO BARTOLOME AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

725 WELCH RD
PALO ALTO CA
94304-1601
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-8000
  • Fax:
Mailing address:
  • Phone: 650-497-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: