=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265148423
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSANA MARIE AMARO AUD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2023
-----------------------------------------------------
Last Update Date | 03/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 450 SUTTER ST RM 1400
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94108-4003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-362-5443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1001 HARVEY DR APT 239
-----------------------------------------------------
City | WALNUT CREEK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94597-3603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-510-7844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 3774
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------