Provider Demographics
NPI:1841734258
Name:GERACI STAUB, JULIANNE (HAD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:GERACI STAUB
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3979 MISSOURI FLAT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5262
Mailing Address - Country:US
Mailing Address - Phone:530-626-7352
Mailing Address - Fax:
Practice Address - Street 1:3979 MISSOURI FLAT RD STE 100
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5262
Practice Address - Country:US
Practice Address - Phone:530-626-7352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7587237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist