Gary Wyatt Andrus, AU.D.
Individual provider Active NPI Audiologist · Ukiah, CA
NPI 1679680417 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1679680417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- AU902 (CA)
- Practice address
- 1165 S Dora St Ste B2
Ukiah, CA 95482-6353 - Phone
- (707) 468-0400
- Fax
- (707) 468-8240
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU902 | CA | MD | Audiologist |
| HA2025 | CA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary Wyatt Andrus | Audiologist-Hearing Aid Fitter | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU902 | CA | Yes |
| Audiologist-Hearing Aid Fitter | 237600000X | HA2025 | CA |
Addresses
Primary practice location
1165 S Dora St Ste B2
Ukiah, CA 95482-6353
Mailing address
1165 S Dora St Ste B2
Ukiah, CA 95482-6353
Phone (707) 468-0400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CGP119690 | Other | CA | CALIFORNIA CHILDREN SRVCS |
| HA0020250 | Medicaid | CA |
Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.