Provider Demographics
NPI:1205338894
Name:PERSONAL HEARING SOLUTIONS
Entity type:Organization
Organization Name:PERSONAL HEARING SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING DEPT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANBOCKERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-538-1000
Mailing Address - Street 1:52 MISSION CIRCLE #203
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-5371
Mailing Address - Country:US
Mailing Address - Phone:707-538-1000
Mailing Address - Fax:707-538-1013
Practice Address - Street 1:181 ANDRIEUX ST STE 106
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6920
Practice Address - Country:US
Practice Address - Phone:707-538-1000
Practice Address - Fax:707-538-1013
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSONAL HEARING SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty