Provider Demographics
NPI:1285125559
Name:TAFOYA-BOCCA, JENNIFER ROSEANNA (AUD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROSEANNA
Last Name:TAFOYA-BOCCA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ROSEANNA
Other - Last Name:BOCCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7225 N ORACLE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6323
Mailing Address - Country:US
Mailing Address - Phone:520-639-8760
Mailing Address - Fax:520-843-4852
Practice Address - Street 1:7225 N ORACLE RD STE 111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6323
Practice Address - Country:US
Practice Address - Phone:520-639-8760
Practice Address - Fax:520-843-4852
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA11302231H00000X
AZ11302237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDA11302OtherARIZONA STATE MEDICAL BOARD