| 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 |
|---|---|
| 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 |
|---|---|---|---|
| 1306595715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | (* (Not Available)) | Primary |
| Provider Name | Jenelle Helene Ezcurra Sandy |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1548548357 PECOS PAC ID: 3476929910 Enrollment ID: I20221027000055 |
| Mailing Address | Practice Location Address |
|---|---|
| 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 | |
Olivia Vinup, AU.D. Audiologist Medicare: Not Enrolled in Medicare Practice Location: 2074 Lake Tahoe Blvd Ste 9, South Lake Tahoe, CA 96150 Phone: 530-537-3344 |