Jan Michael Gamble, AUD

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

3358 Issued in CA

Practice address

756 S Dora St
Ukiah, CA 95482-5336

Phone

(707) 463-2966

NPI assigned

May 3, 2018

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jan Michael De la Cruz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Mendocino Lake Hearing Care, Inc

  dba Mendocino Lake Audiology

  • Audiologist-Hearing Aid Fitter
  • Ukiah, CA
  • NPI 1174250807
  NPD
• Mendocino Lake Audiology Inc.

  • Audiologist-Hearing Aid Fitter
  • Ukiah, CA
  • NPI 1477797082
  NPD (past)
• Microtone Audiology, Inc.

  • Audiologist-Hearing Aid Fitter
  • Napa, CA
  • NPI 1992008320
  NPD (past)

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1386133411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825336",
            "telephone_number": "707-463-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825336",
            "telephone_number": "707-463-2966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lakeport Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954535425",
            "country_code": "US",
            "telephone_number": "707-263-9498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "JAN",
        "middle_name": "MICHAEL",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "11580",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "8189",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "3358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "DE LA CRUZ",
            "middle_name": "MICHAEL",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Julia E Gallichio, LCSW
• Maria Guadalupe Garcia Valdes
• Amanda Darlene Garcia
• Carlos Garcia
• Carlos Garcia
• Diana Garcia, PA-C

• Audiologist-Hearing Aid Fitter in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Audiologist-Hearing Aid Fitter in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.