Provider Demographics
NPI:1992074017
Name:NEUROSPHERE AND AUDIOLOGY INC
Entity type:Organization
Organization Name:NEUROSPHERE AND AUDIOLOGY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:619-400-7972
Mailing Address - Street 1:3326 TRUMBULL ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2423
Mailing Address - Country:US
Mailing Address - Phone:619-400-7972
Mailing Address - Fax:619-456-0011
Practice Address - Street 1:3326 TRUMBULL ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2423
Practice Address - Country:US
Practice Address - Phone:619-400-7972
Practice Address - Fax:619-456-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1293231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty