Healthcare Provider Details

I. General information

NPI: 1770042558
Provider Name (Legal Business Name): JASLEAN AHUJA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 HOLLISTER AVE STE 165
SANTA BARBARA CA
93111-2461
US

IV. Provider business mailing address

5333 HOLLISTER AVE STE 165
SANTA BARBARA CA
93111-2461
US

V. Phone/Fax

Practice location:
  • Phone: 805-967-4200
  • Fax:
Mailing address:
  • Phone: 805-967-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3448
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: