Active NPI
Mary Jane Garnett, AU.D
- Audiologist
- Antioch, CA
National Provider Identifier
1285654764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU473
- Practice address
- 4045 Lone Tree Way
Suite D
Antioch, CA 94531-6200 - Phone
- (925) 778-3298
- Fax
- (925) 778-0937
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU473 | CA | Primary |
Addresses
Primary practice location
4045 Lone Tree Way
Suite D
Antioch, CA 94531-6200
Mailing address
4045 Lone Tree Way
Ste D
Antioch, CA 94531-6206
Phone (925) 778-3298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU0004730 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 473 | CA | MD | Mental Health Counselor |
| AU473 | CA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1285654764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4045 LONE TREE WAY",
"address_2": "STE D",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945316206",
"telephone_number": "925-778-3298",
"fax_number": "925-778-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4045 LONE TREE WAY",
"address_2": "SUITE D",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945316200",
"telephone_number": "925-778-3298",
"fax_number": "925-778-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARNETT",
"first_name": "MARY JANE",
"credential": "AU.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AU0004730",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.