Provider Demographics
NPI:1568021350
Name:FJS HEARING PROFESSIONALS
Entity Type:Organization
Organization Name:FJS HEARING PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-247-1120
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:MIRA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91752
Mailing Address - Country:US
Mailing Address - Phone:909-247-1120
Mailing Address - Fax:909-247-1120
Practice Address - Street 1:5467 MORENO ST
Practice Address - Street 2:SUITE D
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763
Practice Address - Country:US
Practice Address - Phone:909-625-3334
Practice Address - Fax:909-625-3334
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FJS HEARING PROFESSIONALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty