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NPI Code Detail

MEDICARE: KANDACE SAMAAN SLPA

MEDICARE: KANDACE SAMAAN SLPA
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
12355S0801XSpeech-Language Assistant6974CA

General Provider Information

NPI Number : 1376202184
Entity Type Code : Individual
Provider Name (Legal Business Name) : KANDACE SAMAAN SLPA
Provider Business Mailing Address
First Line : 6800 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506
Country : US
Telephone Number : 951-779-1966
Fax Number :
Provider Business Practice Location Address
First Line : 6800 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3835
Country : US
Telephone Number : 951-779-1996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2021
Last Update Date : 12/09/2021

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Directions to “ KANDACE SAMAAN SLPA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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