Provider Demographics
NPI:1114467255
Name:GROSCH, ANN (HA 8179)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:GROSCH
Suffix:
Gender:F
Credentials:HA 8179
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 S BUENA VISTA ST
Mailing Address - Street 2:SUITE 320-A
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4554
Mailing Address - Country:US
Mailing Address - Phone:818-559-9580
Mailing Address - Fax:818-559-1341
Practice Address - Street 1:191 S BUENA VISTA ST
Practice Address - Street 2:SUITE 320-A
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4554
Practice Address - Country:US
Practice Address - Phone:818-559-9580
Practice Address - Fax:818-559-1341
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 8179237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter