Healthcare Provider Details

I. General information

NPI: 1164577433
Provider Name (Legal Business Name): HEARING AND SPEECH CENTER OF NORTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 DIVISADERO ST
SAN FRANCISCO CA
94115-3911
US

IV. Provider business mailing address

1234 DIVISADERO ST
SAN FRANCISCO CA
94115-3911
US

V. Phone/Fax

Practice location:
  • Phone: 415-921-7658
  • Fax: 415-921-2243
Mailing address:
  • Phone: 415-921-7658
  • Fax: 415-921-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRAGH KENNEDY
Title or Position: CEO
Credential:
Phone: 415-921-7658