Healthcare Provider Details

I. General information

NPI: 1255415659
Provider Name (Legal Business Name): SANDI L.B. YBARRA AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 10TH AVE SUITE 110
EUGENE OR
97401-3317
US

IV. Provider business mailing address

401 E 10TH AVE SUITE 110
EUGENE OR
97401-3317
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-3505
  • Fax: 541-686-9067
Mailing address:
  • Phone: 541-686-3505
  • Fax: 541-686-9067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number20878
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number20878
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHASP812171
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierJ177302
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerPACIFICSOURCE
# 2
Identifier325597000001
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerPROVIDENCE MEDICARE EXTRA
# 3
Identifier413473
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer
# 4
Identifier93109519997401A003
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerTRICARE/TRIWEST
# 5
Identifier002480
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: