Healthcare Provider Details

I. General information

NPI: 1750960993
Provider Name (Legal Business Name): KIRSTEN MCWILLIAMS-DOCTOR OF AUDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 UNIVERSITY AVE
SACRAMENTO CA
95825-6708
US

IV. Provider business mailing address

725 UNIVERSITY AVE
SACRAMENTO CA
95825-6708
US

V. Phone/Fax

Practice location:
  • Phone: 916-646-2471
  • Fax: 916-646-2472
Mailing address:
  • Phone: 916-646-2471
  • Fax: 916-646-2472

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: DR. KIRSTEN M MCWILLIAMS
Title or Position: OWNER/AUDIOLOGIST
Credential: AUD
Phone: 530-604-0736