Provider Demographics
NPI:1518288430
Name:RAMACHO-TALLEY, JEANNEANNE MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:JEANNEANNE
Middle Name:MARIE
Last Name:RAMACHO-TALLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:JEANNEANNE
Other - Middle Name:MARIE
Other - Last Name:RAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:44 SEARS CIR
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2824
Mailing Address - Country:US
Mailing Address - Phone:917-755-8794
Mailing Address - Fax:
Practice Address - Street 1:820 BAY AVE STE 210
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2103
Practice Address - Country:US
Practice Address - Phone:831-854-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80437231H00000X
CAAU 3105231H00000X
NC231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist