Provider Demographics
NPI:1740322098
Name:THE HEARING CENTER OF CASTRO VALLEY
Entity type:Organization
Organization Name:THE HEARING CENTER OF CASTRO VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:510-537-4211
Mailing Address - Street 1:20126 STANTON AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5270
Mailing Address - Country:US
Mailing Address - Phone:510-537-4211
Mailing Address - Fax:510-537-3345
Practice Address - Street 1:20126 STANTON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5271
Practice Address - Country:US
Practice Address - Phone:510-537-4211
Practice Address - Fax:510-537-3345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ80378ZMedicaid
CAZZZ80378ZMedicaid