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General NPI Number Information
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NPI Number | 1699591727
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Entity Type | Organization
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Legal Business Name | SANTA ROSA HEARING SPECIALISTS, INC.
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 111 SANTA ROSA AVE STE 115
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City | SANTA ROSA
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State | CA
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Zip | 95404-4944
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Country | US
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Telephone | 707-234-7345
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Fax |
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Provider Business Mailing Address
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Address Line | 111 SANTA ROSA AVE STE 115
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City | SANTA ROSA
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State | CA
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Zip | 95404-4944
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA BEENE
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Credential | AUD
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Telephone | 707-234-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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