Provider Demographics
NPI:1851669949
Name:HEAARING HEALTHCARE PROVIDER OF CALIFORNIA
Entity Type:Organization
Organization Name:HEAARING HEALTHCARE PROVIDER OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-447-1975
Mailing Address - Street 1:ONE CAPITOL MALL
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814
Mailing Address - Country:US
Mailing Address - Phone:916-447-1975
Mailing Address - Fax:916-444-7462
Practice Address - Street 1:ONE CAPITOL MALL
Practice Address - Street 2:SUITE 320
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814
Practice Address - Country:US
Practice Address - Phone:916-447-1975
Practice Address - Fax:916-444-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty