Marincovich, Peter Jansen

Marincovich, Peter Jansen is an sole proprietor health care provider with primary practice located at 1111 Sonoma Avenue Suite 316, Santa Rosa CA 95405. He recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is his primary health care specialty. Marincovich, Peter Jansen can be contacted via phone (707) 523-4740.

Contact Information

Primary practice address
1111 Sonoma Avenue Suite 316 Santa Rosa CA 95405
Phone: (707) 523-4740
Fax: (707) 523-0231
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AU758 California
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X HA1949 California

Profile Details

NPI number 1447327507
LBN Legal business name Marincovich, Peter Jansen
Credentials PHD AUDIOLOGIST DISP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Mar 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447327507 NPPES
California MEDICAID AU0007580
California Other ZZZ03361Z
California Other 640002077
California Other ZZZ03362Z

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