Provider Demographics
NPI:1023158664
Name:AUSTIN, JEANNETTE B
Entity type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:B
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44650 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3326
Mailing Address - Country:US
Mailing Address - Phone:760-340-4290
Mailing Address - Fax:760-340-9726
Practice Address - Street 1:44650 MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3326
Practice Address - Country:US
Practice Address - Phone:760-340-4290
Practice Address - Fax:760-340-9726
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2962237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330855216OtherTAX ID NUMBER