Healthcare Provider Details

I. General information

NPI: 1285333153
Provider Name (Legal Business Name): AUDIOLOGY SPECIALTY CLINICS OF CA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 FAIRWAY DR STE 15
ROCKLIN CA
95677-4246
US

IV. Provider business mailing address

6000 FAIRWAY DR STE 15
ROCKLIN CA
95677-4246
US

V. Phone/Fax

Practice location:
  • Phone: 916-315-8114
  • Fax: 916-315-1316
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY SUE BONNEY
Title or Position: OWNER/PRESIDENT
Credential: AU.D
Phone: 530-263-8753