Provider Demographics
NPI:1689311292
Name:GRANADOS, JANINE VICTORIA (AUD)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:VICTORIA
Last Name:GRANADOS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:VICTORIA
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4019
Mailing Address - Country:US
Mailing Address - Phone:915-532-6935
Mailing Address - Fax:866-623-1203
Practice Address - Street 1:1500 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4019
Practice Address - Country:US
Practice Address - Phone:915-532-6935
Practice Address - Fax:866-623-1203
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81710237600000X, 231H00000X
NMAUD7804237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter