| Pine River Inc. | |
|
1700 Pennsylvania Ave Ste B, Fairfield, CA 94533-3510 | |
| (707) 426-4327 | |
| (707) 426-5190 |
| Full Name | Pine River Inc. |
|---|---|
| Type | Facility |
| Speciality | Audiologist |
| Location | 1700 Pennsylvania Ave Ste B, Fairfield, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639394117 | NPI | - | NPPES |
| AU0004410 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | (* (Not Available)) | Primary |
| Provider Name | Denise L Martin-sahim |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1023182425 PECOS PAC ID: 6800054206 Enrollment ID: I20120214000586 |
| Provider Name | Monica A Guerrero Lara |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528696465 PECOS PAC ID: 3971913930 Enrollment ID: I20201102001764 |
| Mailing Address | Practice Location Address |
|---|---|
| Pine River Inc. 1700 Pennsylvania Ave Ste B, Fairfield, CA 94533-3510 Ph: (707) 426-4327 | Pine River Inc. 1700 Pennsylvania Ave Ste B, Fairfield, CA 94533-3510 Ph: (707) 426-4327 |
Wendy M Schreuder, AUD Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2702 Low Ct, Fairfield, CA 94534 Phone: 707-432-2600 Fax: 707-432-2666 | |
Mrs. Jamie Diane Perro, AUDIOLOGIST Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1287 Oliver Rd, Fairfield, CA 94534 Phone: 707-426-4327 Fax: 707-426-5190 | |
Lorna Leah Wright, M. A. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1700 Pennsylvania Ave Ste B, Fairfield, CA 94533 Phone: 707-651-2688 | |
Dr. Dimitrios Michael Palilis, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 744 Empire St # 210, Fairfield, CA 94533 Phone: 707-759-4419 Fax: 510-483-3685 |