Provider Demographics
NPI:1417129479
Name:EARS HEARING HEALTHCARE, INC
Entity Type:Organization
Organization Name:EARS HEARING HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JESPERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:760-775-1113
Mailing Address - Street 1:81833 DOCTOR CARREON BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5590
Mailing Address - Country:US
Mailing Address - Phone:760-775-1113
Mailing Address - Fax:760-775-3222
Practice Address - Street 1:81833 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5590
Practice Address - Country:US
Practice Address - Phone:760-775-1113
Practice Address - Fax:760-775-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1216237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAO547AMedicare PIN