Glynis G Tambornini, M.S., CCC-A

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

AU1445 Issued in CA

Practice address

756 S Dora St
Ukiah, CA 95482-5336

Phone

(707) 463-2966

Fax

(707) 463-2970

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Mendocino Lake Hearing Care, Inc

  dba Mendocino Lake Audiology

  • Audiologist-Hearing Aid Fitter
  • Ukiah, CA
  • NPI 1174250807
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942358395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825336",
            "telephone_number": "707-463-2966",
            "fax_number": "707-463-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825336",
            "telephone_number": "707-463-2966",
            "fax_number": "707-463-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBORNINI",
        "first_name": "GLYNIS",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU1445",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "HA2483",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DIAGNOSTICS",
            "identifier": "ZZZ57005Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DME",
            "identifier": "ZZZ57006Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Swift
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• Megan Brianna Talbert
• Philip Masao Tamanaha, M.D.
• Mohammad Tamim
• Hendrik Ryan Lumakang Tan, DPM
• Robert Blake Tandy, D.D.S., M.S.
• Deborah L. Tannenbaum
• Tapestry Family Services

• Audiologist-Hearing Aid Fitter in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Audiologist-Hearing Aid Fitter in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.