Active NPI
Anna W Dodge, AUD
- Audiologist
- Santa Cruz, CA
National Provider Identifier
1710266424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU2791
- Practice address
- 1595 Soquel Dr
230
Santa Cruz, CA 95065-1719 - Phone
- (831) 476-4414
- NPI assigned
- Aug 11, 2011
- Last updated
- Aug 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU2791 | CA | Primary |
Addresses
Primary practice location
1595 Soquel Dr
230
Santa Cruz, CA 95065-1719
Mailing address
1595 Soquel Drive
230
Soquel, CA 95065
Phone (831) 476-4414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU2791 | Other | CA | SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU2791 | CA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1710266424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 SOQUEL DRIVE",
"address_2": "230",
"city": "SOQUEL",
"state": "CA",
"postal_code": "95065",
"telephone_number": "831-476-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 SOQUEL DR",
"address_2": "230",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651719",
"telephone_number": "831-476-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "ANNA",
"middle_name": "W",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-11",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU2791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY BOARD",
"identifier": "AU2791",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.