Active NPI
Jane Petersen, AUDIOLOGIST
- Audiologist
- La Mesa, CA
National Provider Identifier
1811618986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1081
- Practice address
- 5020 Baltimore Dr Ste a
La Mesa, CA 91942-0692 - Phone
- (619) 460-0180
- NPI assigned
- Sep 7, 2022
- 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 | 1081 | CA | Primary |
Addresses
Primary practice location
5020 Baltimore Dr Ste a
La Mesa, CA 91942-0692
Mailing address
5020 Baltimore Dr Ste a
La Mesa, CA 91942-0692
Phone (619) 460-0180
Other practice location 1
7420 Clairemont Mesa Blvd Ste 119
San Diego, CA 92111-1546
Phone (619) 460-0180
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1081 | CA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carpadakis Hearing, Inc | Current | Accepting new patients | |
| Carpadakis Hearing, Inc | Current | Accepting new patients |
Locations
5020 Baltimore Dr
Ste A
La Mesa, CA 91942
Phone (619) 460-0180
7420 Clairemont Mesa Blvd
Ste 119
San Diego, CA 92111
Phone (619) 460-0180
Organizations & group practices 2
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.
-
- Hearing Instrument Specialist
- La Mesa, CA
- NPI 1134676083
-
- Hearing Aid Equipment
- San Diego, CA
- NPI 1942833587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1811618986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5020 BALTIMORE DR STE A",
"city": "LA MESA",
"state": "CA",
"postal_code": "919420692",
"telephone_number": "619-460-0180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5020 BALTIMORE DR STE A",
"city": "LA MESA",
"state": "CA",
"postal_code": "919420692",
"telephone_number": "619-460-0180"
}
],
"practiceLocations": [
{
"address_1": "7420 Clairemont Mesa Blvd Ste 119",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921111546",
"country_code": "US",
"telephone_number": "619-460-0180",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSEN",
"first_name": "JANE",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-07",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "1081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.