Provider Demographics
NPI:1386908408
Name:VERCI JEWELRY CORP
Entity type:Organization
Organization Name:VERCI JEWELRY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEARING AID SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLASENOR
Authorized Official - Suffix:
Authorized Official - Credentials:HAD
Authorized Official - Phone:818-346-1932
Mailing Address - Street 1:20610 ARCHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-4009
Mailing Address - Country:US
Mailing Address - Phone:818-349-1932
Mailing Address - Fax:818-346-1676
Practice Address - Street 1:22554 VENTURA BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1413
Practice Address - Country:US
Practice Address - Phone:818-346-1932
Practice Address - Fax:818-346-1676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA4051261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech