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NPI Code Detail

MEDICARE: LEORA SHAFFER MA CCC-SLP

MEDICARE: LEORA SHAFFER MA CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP8157CA

General Provider Information

NPI Number : 1053819391
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEORA SHAFFER MA CCC-SLP
Provider Business Mailing Address
First Line : 2023 RAINBOW DR
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4010 BARRANCA PKWY STE 220
Second Line :
City : IRVINE
State : CA
Zip : 92604-1721
Country : US
Telephone Number : 949-857-6051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 01/31/2018

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Directions to “ LEORA SHAFFER MA CCC-SLP” Practice Location

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