Provider Demographics
NPI:1013156363
Name:SOUND HEARING SERVICES
Entity Type:Organization
Organization Name:SOUND HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:707-446-0742
Mailing Address - Street 1:673B MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-6907
Mailing Address - Country:US
Mailing Address - Phone:707-446-0742
Mailing Address - Fax:707-446-5307
Practice Address - Street 1:673B MERCHANT ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-6907
Practice Address - Country:US
Practice Address - Phone:707-446-0742
Practice Address - Fax:707-446-5307
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINE RIVER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1089237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA237600000XMedicaid
CA237600000XMedicaid