MEDICARE: JENNIFER FRAZELLE HA 8174

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	237700000X	Hearing Instrument Specialist	HA8174	CA

General Provider Information

NPI Number	:	1770092660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER FRAZELLE HA 8174

Provider Business Mailing Address
First Line	:	6601 BRIARTREE WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-1009
Country	:	US
Telephone Number	:	916-725-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 BRIARTREE WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-1009
Country	:	US
Telephone Number	:	916-725-0222
Fax Number	:

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

Provider Enumeration Date	:	09/24/2017
Last Update Date	:	07/21/2022

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