Carissa Bennett, Aud, Inc

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AU759 Issued in CA

Legal business name

CARISSA BENNETT, AUD, INC

Practice address

633 N Central Ave
Suite #201
Glendale, CA 91203-1801

Phone

(818) 500-0662

Fax

(818) 500-0803

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carissa Darlene Bennett, AU.D.NPI 1104869551

Title

President

Phone

(818) 500-0662

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carissa Darlene Bennett, AUD

  • Specialist
  • Los Angeles, CA
  • NPI 1104869551
  NPD (past) Authorized official
• Gregory James Frazer, AU.D. , PH.D.

  • Audiologist
  • Los Angeles, CA
  • NPI 1023051588
  NPD (past)
• Marni Lisa Novick, AU.D.

  • Audiologist
  • Los Gatos, CA
  • NPI 1336176676
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801917547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 DWIGHT DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071315",
            "telephone_number": "818-500-0662",
            "fax_number": "818-500-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N CENTRAL AVE",
            "address_2": "SUITE #201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031801",
            "telephone_number": "818-500-0662",
            "fax_number": "818-500-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARISSA BENNETT, AUD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-500-0662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Glendale, CA
• Providers in Glendale, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.