Provider Demographics
NPI:1184139859
Name:SAN JOAQUIN HEARING
Entity type:Organization
Organization Name:SAN JOAQUIN HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:209-200-9119
Mailing Address - Street 1:4568 FEATHER RIVER DR STE C
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-6503
Mailing Address - Country:US
Mailing Address - Phone:209-951-6491
Mailing Address - Fax:
Practice Address - Street 1:3244 BROOKSIDE RD STE 180
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2382
Practice Address - Country:US
Practice Address - Phone:209-951-6491
Practice Address - Fax:209-951-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty