Provider Demographics
NPI:1356486708
Name:SANDERS, CHARLES TIMOTHY (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:TIMOTHY
Last Name:SANDERS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 UNIVERSITY AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6706
Mailing Address - Country:US
Mailing Address - Phone:916-927-9640
Mailing Address - Fax:916-927-9641
Practice Address - Street 1:601 UNIVERSITY AVE STE 105
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6706
Practice Address - Country:US
Practice Address - Phone:916-927-9640
Practice Address - Fax:916-927-9641
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2268231H00000X, 237600000X, 231H00000X, 237600000X
235500000X, 2355A2700X, 237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist