Healthcare Provider Details

I. General information

NPI: 1932424736
Provider Name (Legal Business Name): PATRICIA MOUCK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR STE 2
SAN DIEGO CA
92134-1002
US

IV. Provider business mailing address

34800 BOB WILSON DR STE 2
SAN DIEGO CA
92134-1002
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: