Provider Demographics
NPI:1750543187
Name:DAVIS, ROSE MARIE SCHLEIF (AUD)
Entity type:Individual
Prefix:DR
First Name:ROSE MARIE
Middle Name:SCHLEIF
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ROSEMARIE
Other - Middle Name:SCHLEIF
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30532 MIRANDELA LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2346
Mailing Address - Country:US
Mailing Address - Phone:949-395-3340
Mailing Address - Fax:949-395-3340
Practice Address - Street 1:30030 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2046
Practice Address - Country:US
Practice Address - Phone:949-395-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAUD 350237600000X
CAHA 7294237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1750543187Medicare PIN