Active NPI
Hearing Services of Antioch a Professional Audiology Corpration
- Audiologist
- Antioch, CA
National Provider Identifier
1619990488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU473
- Legal business name
- HEARING SERVICES OF ANTIOCH A PROFESSIONAL AUDIOLOGY CORPRATION
- Practice address
- 4045 Lone Tree Way
Suite D
Antioch, CA 94531-6200 - Phone
- (925) 778-3298
- Fax
- (925) 778-0937
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Jane Garnett, AU.D
- Title
- Owner
- Phone
- (925) 778-3298
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU473 | CA | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | HA3465 | CA |
Addresses
Primary practice location
4045 Lone Tree Way
Suite D
Antioch, CA 94531-6200
Mailing address
4045 Lone Tree Way
Suite D
Antioch, CA 94531-6200
Phone (925) 778-3298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU0004730 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591228800000",
"number": "1619990488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"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"
},
{
"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": {
"organization_name": "HEARING SERVICES OF ANTIOCH A PROFESSIONAL AUDIOLOGY CORPRATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-25",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A",
"authorized_official_last_name": "GARNETT",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "JANE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "925-778-3298",
"authorized_official_credential": "AU.D"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Audiologist",
"state": "CA",
"license": "AU473",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "CA",
"license": "HA3465",
"primary": false
}
],
"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 Jun 4, 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.