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General NPI Number Information
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NPI Number | 1427744515
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Entity Type | Individual
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Provider Name | AMANDA GAYLE BRAWDERS HIS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 3003 LOMA VISTA RD STE C
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City | VENTURA
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State | CA
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Zip | 93003-2941
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Country | US
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Telephone | 805-648-1685
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Fax |
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Provider Business Mailing Address
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Address Line | 233 AZALEA ST
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City | FILLMORE
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State | CA
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Zip | 93015-2240
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Country | US
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Telephone | 805-901-8645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA8098
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License Number State | CA
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