Tahoe Family Hearing Clinic, Pc | |
2074 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6407 | |
(530) 318-4010 | |
Not Available |
Full Name | Tahoe Family Hearing Clinic, Pc |
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Type | Facility |
Speciality | Audiologist |
Location | 2074 Lake Tahoe Blvd, South Lake Tahoe, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1306595715 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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231H00000X | Audiologist | (* (Not Available)) | Primary |
Provider Name | Jenelle Helene Ezcurra Sandy |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1548548357 PECOS PAC ID: 3476929910 Enrollment ID: I20221027000055 |
Mailing Address | Practice Location Address |
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Tahoe Family Hearing Clinic, Pc 1285 Apache Ave # 306, South Lake Tahoe, CA 96155-7672 Ph: (530) 318-4010 | Tahoe Family Hearing Clinic, Pc 2074 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6407 Ph: (530) 318-4010 |
Jenelle Helene Ezcurra Sandy, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 2074 Lake Tahoe Blvd, South Lake Tahoe, CA 96150 Phone: 530-318-4010 | |
Danielle Marie Knowlton, MA, FAAA Audiologist Medicare: Not Enrolled in Medicare Practice Location: 2169 South Ave, South Lake Tahoe, CA 96150 Phone: 530-543-5815 Fax: 530-544-3875 |