Individual provider Active NPI

Providence M Alvira, AU.D CCC-A

  • Audiologist-Hearing Aid Fitter
  • San Diego, CA
National Provider Identifier
1669645776
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
1745 Issued in CA
Practice address
6367 Alvarado CT
Ste 101
San Diego, CA 92120-4904
Phone
(619) 583-7002
Fax
(619) 583-9404
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 1745 CA Primary

Addresses

Primary practice location

6367 Alvarado CT
Ste 101
San Diego, CA 92120-4904

Mailing address

12927 Sleepy Wind St
Moorpark, CA 93021-2935
Phone (310) 989-3092

Other identifiers 1

IdentifierTypeStateIssuer
1669645776MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000746 CA Practitioner - Qualified Audiologist 0143408104 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serendipity Hearing IncGroup PAC ID 4587849054, 11 clinicians

Practice addresses (Care Compare)

1820 Marron Rd
Suite 102
Carlsbad, CA 92008-1177
Phone (760) 434-0125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ashish K Wadhwa MD a Medical Corporation CurrentSince Jul 12, 2021 Accepting new patients
Serendipity Hearing Inc Audiologist-Hearing Aid Fitter CurrentSince Jun 28, 2025 Accepting new patients
Palomar Health PastSince Jul 12, 2021 Accepting new patients

Locations

1820 Marron Rd
Ste 102
Carlsbad, CA 92008
Phone (760) 434-0125

310 Third Ave
Ste B21
Chula Vista, CA 91910
Phone (619) 426-0841

310 Third Ave
Ste C11
Chula Vista, CA 91910
Phone (619) 426-0841

12630 Monte Vista Rd
Ste 206
Poway, CA 92064
Phone (858) 355-0244

399 E Highland Ave
Ste 117
San Bernardino, CA 92404
Phone (909) 372-0016

6367 Alvarado Ct
Ste 101
San Diego, CA 92120
Phone (619) 583-7002

5555 Garden Grove Blvd
Ste 200
Westminster, CA 92683
Phone (714) 804-5725

5000 Cheshire Pkwy N
Plymouth, MN 55446
Phone (888) 333-9152

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1669645776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12927 SLEEPY WIND ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212935",
            "telephone_number": "310-989-3092",
            "fax_number": "805-530-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6367 ALVARADO CT",
            "address_2": "STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204904",
            "telephone_number": "619-583-7002",
            "fax_number": "619-583-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVIRA",
        "first_name": "PROVIDENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "AU.D CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "1745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669645776",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.