Provider Demographics
NPI:1669473195
Name:EHRLICH, BETH L (AUD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:L
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-866-3400
Mailing Address - Fax:510-506-7729
Practice Address - Street 1:20101 LAKE CHABOT RD FL 3
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5305
Practice Address - Country:US
Practice Address - Phone:510-886-3400
Practice Address - Fax:510-506-7729
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-12-03
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
CAHA1531237600000X
CAAU433231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU433OtherSTATE MEDICAL LICENSE
CAZZZ96759ZMedicare PIN