Provider Demographics
NPI:1558661207
Name:NANCY SHANE, AU.D.
Entity Type:Organization
Organization Name:NANCY SHANE, AU.D.
Other - Org Name:AUDIOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SHANE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:415-933-6100
Mailing Address - Street 1:1000 DRAKES LANDING RD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904
Mailing Address - Country:US
Mailing Address - Phone:415-933-6100
Mailing Address - Fax:415-379-9910
Practice Address - Street 1:1 SHRADER ST.
Practice Address - Street 2:SUITE 510
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117
Practice Address - Country:US
Practice Address - Phone:415-933-6100
Practice Address - Fax:415-379-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1410231H00000X
332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid Equipment
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty