Provider Demographics
NPI:1407211899
Name:BAHR, ASHLEY E (AUD, CCC-A, CNIM)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:BAHR
Suffix:
Gender:F
Credentials:AUD, CCC-A, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 CAMINO DEL RIO S STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3817
Mailing Address - Country:US
Mailing Address - Phone:515-505-8242
Mailing Address - Fax:
Practice Address - Street 1:2815 CAMINO DEL RIO S STE 220
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3817
Practice Address - Country:US
Practice Address - Phone:858-279-6772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073592231H00000X
IA073593237700000X
CA3474231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist