MEDICARE: DR. JANELY ABOOTORABI AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AU3644	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER	CA	NA

General Provider Information

NPI Number	:	1588236483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANELY ABOOTORABI AU.D.

Provider Business Mailing Address
First Line	:	1200 RICKABAUGH WAY UNIT 539
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-3153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 S. BASCOM AVE
Second Line	:	BUILDING Q, 4TH FLOOR, SUITE 410
City	:	SANTA CLARA
State	:	CA
Zip	:	95050
Country	:	US
Telephone Number	:	408-885-4681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	01/07/2026

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