MEDICARE: SAIDEE REGIS SPA 2307

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SPA2307	CA

General Provider Information

NPI Number	:	1013851880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAIDEE REGIS SPA 2307

Provider Business Mailing Address
First Line	:	435 S PACIFIC AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 S PACIFIC AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-1441
Country	:	US
Telephone Number	:	818-241-1807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ SAIDEE REGIS SPA 2307” Practice Location

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