Provider Demographics
NPI:1801011143
Name:BARGETTO, GINA DOMENICA (AUD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:DOMENICA
Last Name:BARGETTO
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 1:5831 COTTLE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3734
Mailing Address - Country:US
Mailing Address - Phone:408-363-4801
Mailing Address - Fax:408-363-4813
Practice Address - Street 1:5831 COTTLE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3734
Practice Address - Country:US
Practice Address - Phone:408-363-4801
Practice Address - Fax:408-363-4813
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1938231HA2400X, 231HA2500X, 231H00000X
CAHA3915237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist