Provider Demographics
NPI:1861412751
Name:DANHAUER, JEFFREY TATUM (MA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TATUM
Last Name:DANHAUER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 HOLLISTER AVE
Mailing Address - Street 2:STE.1
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2334
Mailing Address - Country:US
Mailing Address - Phone:805-696-6811
Mailing Address - Fax:805-696-6453
Practice Address - Street 1:5360 HOLLISTER AVE
Practice Address - Street 2:STE.1
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2334
Practice Address - Country:US
Practice Address - Phone:805-696-6811
Practice Address - Fax:805-696-6453
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1984231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0001984Medicaid
CAAU0001984AMedicaid
CAAU0001984AMedicaid
CAAU0001984Medicaid