| |
4132 Katella Avenue, Suite 204, Los Alamtios, CA 90720-6601 | |
(562) 598-9555 | |
(562) 598-9898 |
Full Name | |
---|---|
Type | Facility |
Speciality | Speech-language Pathologist |
Location | 4132 Katella Avenue, Los Alamtios, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649350570 | NPI | - | NPPES |
SP0041760 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | SP4176 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
4132 Katella Avenue, Suite 204, Los Alamtios, CA 90720-6601 Ph: (562) 598-9555 | 4132 Katella Avenue, Suite 204, Los Alamtios, CA 90720-6601 Ph: (562) 598-9555 |