Provider Demographics
NPI:1851321517
Name:PLACER SPEECH & HEARING SERVICES OF AUBURN, INC
Entity type:Organization
Organization Name:PLACER SPEECH & HEARING SERVICES OF AUBURN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/AUBIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANENE L
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAUHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:530-823-7532
Mailing Address - Street 1:11775 EDUCATION ST STE 102
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-2453
Mailing Address - Country:US
Mailing Address - Phone:530-823-7532
Mailing Address - Fax:530-823-0316
Practice Address - Street 1:11775 EDUCATION ST STE 102
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2453
Practice Address - Country:US
Practice Address - Phone:530-823-7532
Practice Address - Fax:530-823-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP8514235Z00000X
CAAU1501231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31535ZOtherBLUE SHIELD
CAGAU000550Medicaid
CAZZZ57187ZOtherBLUE CROSS
CA990008341Medicare ID - Type UnspecifiedRAILROAD MEDICARE
CAGAU000550Medicaid