Provider Demographics
NPI:1447440920
Name:PEDIATRIC HEARING SPECIALISTS, INC.
Entity type:Organization
Organization Name:PEDIATRIC HEARING SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:760-634-1553
Mailing Address - Street 1:2210 ENCINITAS BLVD
Mailing Address - Street 2:SUITE O
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4376
Mailing Address - Country:US
Mailing Address - Phone:760-634-1553
Mailing Address - Fax:760-634-1660
Practice Address - Street 1:2210 ENCINITAS BLVD
Practice Address - Street 2:SUITE O
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4376
Practice Address - Country:US
Practice Address - Phone:760-634-1553
Practice Address - Fax:760-634-1660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1225237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty