Provider Demographics
NPI:1720331648
Name:HARDEN, BENJAMIN LEE (AUD, CCC-A, FAAA)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LEE
Last Name:HARDEN
Suffix:
Gender:M
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 AIRPORT BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2020
Mailing Address - Country:US
Mailing Address - Phone:650-240-8198
Mailing Address - Fax:408-328-5695
Practice Address - Street 1:1501 TROUSDALE DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4506
Practice Address - Country:US
Practice Address - Phone:650-652-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-993-AU231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist