Randall Bartlett, MA
Individual provider Active NPI Specialist · Santa Clarita, CA
NPI 1013042928 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1013042928
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- HA 1195 (CA)
- Practice address
- 23033 Lyons Ave
Suite 3
Santa Clarita, CA 91321-2727 - Phone
- (661) 259-1687
- Fax
- (661) 259-9684
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2018 through Oct 1, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD 444 | CA | MD | Specialist |
| HA 1195 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Services of Newhall | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AUD 444 | CA | |
| Specialist | 174400000X | HA 1195 | CA | Yes |
Addresses
Primary practice location
23033 Lyons Ave
Suite 3
Santa Clarita, CA 91321-2727
Mailing address
23033 Lyons Ave
Suite 3
Santa Clarita, CA 91321-2727
Phone (661) 259-1687
Other providers in Santa Clarita, CA
- Josselyn Barriga
- Shawn M Barrington
- Klint Emilio Barrios
- Briana Barron
- Victoria Barry
- Jasmine Estepa Barton
- Karen C. Barton
- Padmini Baruah
- Lauren Nga Bass
- Ravinder Kaur Bassan
All providers in Santa Clarita, CA · Specialist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.