PETER JANSEN MARINCOVICH (NPI# 1447327507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447327507 |
| Entity Type | Individual |
| Full Name | PETER JANSEN MARINCOVICH |
| Credential | PHD AUDIOLOGIST DISP |
| Practice Address |
1111 Sonoma Avenue Suite 316 Santa Rosa CA 95405 |
| Practice Telephone | 7075234740 |
| Practice Fax Number | 7075230231 |
| Mailing Telephone | 7075234740 |
| Mailing Fax Number | 7075230231 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2013-03-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | AU758 | CA | Speech, Language and Hearing Service Providers |
| N | 237600000X | Audiologist-Hearing Aid Fitter | HA1949 | CA | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ03361Z | 01 |
| CA | BLUE SHIELD | ZZZ03362Z | 01 |
| CA | AU0007580 | 05 | |
| CA | RRM | 640002077 | 01 |
| Street Address |
1111 SONOMA AVENUE SUITE 316 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811902612 | Lela M Emad | Obstetrics & Gynecology | 1111 Sonoma Avenue, Suite 202, Santa Rosa, CA 95405 | 2006-07-30 |
| 1316439979 | Women's Obgyn | Clinic/Center | 1111 Sonoma Avenue, Suite 202, Santa Rosa, CA 95405 | 2018-05-30 |
| 1982716221 | Susan C Logan | Obstetrics & Gynecology | 1111 Sonoma Avenue, Suite 202, Santa Rosa, CA 95405 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497898043 | Marina Marie Mulvey | Audiologist | 4725 Hoen Avenue, Suite B, Santa Rosa, CA 95405-9405 | 2007-02-14 |
| 1548310188 | Kathy Matonak | Audiologist | 3333 Mendocino Ave, Suite 240, Santa Rosa, CA 95403-2261 | 2007-01-12 |
| 1295884260 | Sheila Burnett Burke | Audiologist | 401 Bicentennial Way Ste 180, Santa Rosa, CA 95403-2149 | 2007-01-09 |
| 1184785339 | Julie Diane Hartz | Audiologist | 3333 Mendocino Ave Ste 240, Santa Rosa, CA 95403-3631 | 2006-12-12 |
| 1104933753 | Candace Alene Mcghee | Audiologist | 4584 Petaluma Hill Rd, Santa Rosa, CA 95404-9787 | 2006-08-23 |
| 1477598050 | William Diles Inc | Audiologist | 52 Mission Cir, Suite 203, Santa Rosa, CA 95409-5369 | 2006-06-18 |
| 1083222988 | Malica Ly | Audiologist | 4725 Hoen Ave Ste B, Santa Rosa, CA 95405-9405 | 2020-07-16 |
| 1992347603 | Daniel S Park | Audiologist | 1111 Sonoma Ave Ste 316, Santa Rosa, CA 95405-4820 | 2019-10-14 |
| 1285146902 | Laura Marie Schmitt | Audiologist | 3841 Brickway Blvd, Santa Rosa, CA 95403-8226 | 2017-11-03 |
| 1598288060 | Samantha Charlotte Lenzini | Audiologist | 98 Montgomery Dr, Santa Rosa, CA 95404-6615 | 2017-07-17 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.