# TAHOE FAMILY HEARING CLINIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306595715
- **Authorized official:** JENELLE SANDY AUD (OWNER/AUDIOLOGIST)
- **Authorized official phone:** (530) 318-4010

## Contact information

- **Practice address:** 2074 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-6407
- **Practice address phone:** (530) 318-4010
- **Mailing address:** 1285 APACHE AVE \# 306, SOUTH LAKE TAHOE, CA 96155-7672
- **Mailing address phone:** (530) 318-4010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | NULL | Yes |
| 231H00000X | Audiologist | — | — | Yes |

## Other

- **Enumeration date:** 03/22/2022
- **Last updated:** 10/26/2022