Malica Ly

Primary specialty

AudiologistTaxonomy code 231H00000X

License

13592 Issued in CA

Practice address

4725 Hoen Ave Ste B
Santa Rosa, CA 95405-9405

Phone

(707) 542-1154

Fax

(707) 542-4818

NPI assigned

Jul 16, 2020

Last updated

Jul 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • Oxnard, CA
  • NPI 1104178136

  Audiologist

  NPD (past)
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • San Jose, CA
  • NPI 1265785182

  Audiologist

  NPD (past)
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • Upland, CA
  • NPI 1295088136

  Audiologist

  NPD (past)
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • Daly City, CA
  • NPI 1558606582

  Audiologist

  NPD (past)
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • San Marcos, CA
  • NPI 1710238035

  Audiologist

  NPD (past)
• Connect Hearing, Inc.

  • Hearing Aid Equipment
  • West Covina, CA
  • NPI 1992058648

  Audiologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1083222988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047940",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 HOEN AVE STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954059405",
            "telephone_number": "707-542-1154",
            "fax_number": "707-542-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 Healdsburg Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Healdsburg",
            "state": "CA",
            "postal_code": "954483409",
            "country_code": "US",
            "telephone_number": "707-433-0705",
            "fax_number": "707-433-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "MALICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "13592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc. (Lenscrafters #215)
• Luxottica of America Inc. (Lenscrafters at Macys #7476)
• Luxottica of America Inc. (Target Optical #2953)
• Amanda Ly, MD
• Bao G Ly, RPH
• Stephanie Dung Ly, PHARMD
• Timothy Lydon, CRC
• April Renee Lynch
• Christine Lynch, P.T.
• Emily Lynch, FNP-C

• Audiologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.