| Dallas Rose Innis, AUD | |
|
975 Sereno Dr, Vallejo, CA 94589-2441 | |
| (707) 651-2500 | |
| Not Available |
| Full Name | Dallas Rose Innis |
|---|---|
| Gender | Female |
| Speciality | Qualified Audiologist |
| Experience | 1 Years |
| Location | 975 Sereno Dr, Vallejo, California |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720896129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | (* (Not Available)) | Primary |
| Provider Name | Permanente Medical Group Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Rose Innis, AUD 2100 5th St Apt 146, Davis, CA 95618-6600 Ph: (936) 755-0004 | Dallas Rose Innis, AUD 975 Sereno Dr, Vallejo, CA 94589-2441 Ph: (707) 651-2500 |
Champa Sreenivas, Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1761 Broadway St Ste 200, Vallejo, CA 94589 Phone: 707-645-2500 | |
Lisa Michelle Termansen, M.S. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1761 Broadway St, Suite 200, Vallejo, CA 94589 Phone: 707-645-2500 | |
Jennifer Rose Woods Tyler, AU.D Audiologist Medicare: Not Enrolled in Medicare Practice Location: 975 Sereno Dr, Vallejo, CA 94589 Phone: 707-651-1000 | |
Zarghona Fazli, Audiologist Medicare: Medicare Enrolled Practice Location: 1761 Broadway St Ste 200, Vallejo, CA 94589 Phone: 707-645-2500 |