MEDICARE: VALERIE M VEGA 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
1	235Z00000X	Speech-Language Pathologist	36086	CA

General Provider Information

NPI Number	:	1437924735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE M VEGA SLP

Provider Business Mailing Address
First Line	:	PO BOX 4505
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-0505
Country	:	US
Telephone Number	:	626-373-6981
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 SPRING ST
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-4930
Country	:	US
Telephone Number	:	626-780-5944
Fax Number	:

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

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

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Directions to “ VALERIE M VEGA SLP” Practice Location

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