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SAN DIEGO STATE UNIVERSITY SPEECH, LANGUAGE AND HEARING CLINIC
NPI 1972964468
Audiologist-Hearing Aid Fitter in San Diego, CA

Active since March 11, 2016CLIA 05D0060831 · Accreditation
5500 CAMPANILE DR, SAN DIEGO, CA 92182(619) 594-7747(619) 594-5917 Get Directions Write a Review

NPPES record last updated: March 11, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About San Diego State University Speech, Language And Hearing Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN DIEGO STATE UNIVERSITY SPEECH, LANGUAGE AND HEARING CLINIC (NPI 1972964468) is a healthcare organization registered as an audiologist-hearing aid fitter in San Diego, California and active in the NPI registry since March 2016. The organization holds an CLIA Accreditation certificate valid through December 15, 2026 and lists Agnes Wong Nickerson, Associate Vp Of Financial Operation, as its authorized official.

NPPES Registry Identity

NPI1972964468
Entity TypeOrganization
Primary Taxonomy237600000X
Legal Business NameSAN DIEGO STATE UNIVERSITY
Location Address5500 CAMPANILE DRSan Diego, CA 92182-1518
Mailing Address5500 Campanile DrSan Diego, CA 92182-1518 · (619) 594-7747 · Fax (619) 594-5917
Phone(619) 594-7747
Fax(619) 594-5917
Organization SubpartYes
Authorized OfficialAgnes Wong NickersonAssociate Vp Of Financial Operation · (619) 594-6017
Enumeration DateMarch 11, 2016
✔ NPI 1972964468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAudiologist-Hearing Aid FitterSpeech, Language and Hearing Service Providers
Taxonomy Code237600000X
Definition

An audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of tests to determine the exact nature of an individual's hearing problem, presents a variety of treatment options to patients, dispenses and fits hearing aids, administers tests of balance to evaluate dizziness and provides hearing rehabilitation training. This classification should be used where individuals are licensed as audiologist-hearing aid fitters as opposed to states that license individuals as audiologists.

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
5500 CAMPANILE DR, San Diego, CA 92182
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Other Names 1

Other NameSan Diego State University Speech, Language And Hearing Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D0060831

San Diego State University Student Health Services Lab · San Diego, CA
Active · expires Dec 15, 2026
CLIA Number05D0060831
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateDecember 16, 2024
Certificate Expiration DateDecember 15, 2026
Laboratory DirectorDr. Diane R. Fernandez
Laboratory Phone(619) 594-5947
Laboratory LocationSan Diego State University Student Health Services Lab5700 Hardy Ave, Rm 2400, San Diego, CA 92182
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENISE ANN WIKSTEN PHD, ATC
Specialist/Technologist (Athletic Trainer)
5500 CAMPANILE DR, DEPT. OF EXERCISE & NUTRITIONAL SCIENCES
SAN DIEGO, CA 92182
San Diego County (619) 594-6825
SAN DIEGO STATE UNIVERSITY STUDENT HEALTH SERVICES
Clinic/Center
5500 CAMPANILE DR
SAN DIEGO, CA 92182
San Diego County (619) 594-4325
MS. TERESA RENEE BERTINO NP
Nurse Practitioner (Adult Health)
5500 CAMPANILE DR
SAN DIEGO, CA 92182
San Diego County (619) 594-6681
MARTIN GREENBERG
Psychiatry & Neurology (Psychiatry)
5500 CAMPANILE DR, STUDENT HEALTH-SDSU
SAN DIEGO, CA 92182
San Diego County (619) 594-7316
DR. GREGG ALAN LICHTENSTEIN M.D.
Family Medicine (Adult Medicine)
5500 CAMPANILE DR, STUDENT HEALTH SERVICES SAN DIEGO STATE UNIVERSITY
SAN DIEGO, CA 92182
San Diego County (619) 594-5281
SUE ANN HADLEY APRN
Nurse Practitioner
5500 CAMPANILE DR
SAN DIEGO, CA 92182
San Diego County (619) 594-2770
CAROL A BOYLE NP
Nurse Practitioner (Family)
5500 CAMPANILE DR
SAN DIEGO, CA 92182
San Diego County (619) 594-6681
MS. JILL MARIE DAVIS-PRICKETT NP
Nurse Practitioner (Family)
5500 CAMPANILE DR
SAN DIEGO, CA 92182
San Diego County (619) 594-6681

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Diego State University's NPI number?

The NPI number for San Diego State University is 1972964468. It was assigned to this organization in the NPPES registry on March 11, 2016. The provider is also known as San Diego State University Speech, Language And Hearing Clinic.

Where is San Diego State University located?

San Diego State University is located at 5500 Campanile Dr, San Diego, CA 92182. The listed phone number is (619) 594-7747.

What is San Diego State University's specialty?

The primary specialty registered for this NPI is Audiologist-Hearing Aid Fitter with taxonomy code 237600000X.

Does San Diego State University hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D0060831) is associated with this NPI, valid through December 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Diego State University was last updated on March 11, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.