Provider Demographics
NPI:1356756274
Name:VENTURE PATHWAYS LLC
Entity type:Organization
Organization Name:VENTURE PATHWAYS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS, ACA
Authorized Official - Phone:805-547-9500
Mailing Address - Street 1:PO BOX 13759
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-3759
Mailing Address - Country:US
Mailing Address - Phone:805-547-9500
Mailing Address - Fax:805-547-9502
Practice Address - Street 1:3830 BROAD ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7187
Practice Address - Country:US
Practice Address - Phone:805-547-9500
Practice Address - Fax:805-547-9502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VENTURE PATHWAYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3908332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment