Organization Active NPI

Hearing Services of Antioch a Professional Audiology Corpration

  • Audiologist
  • Antioch, CA
National Provider Identifier
1619990488
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU473 Issued in CA
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

Updated by the provider on Jun 4, 2020

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)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X AU473 CA Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
AU0004730MedicaidCA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.