MEDICARE: DEVELOPMENTAL THERAPY SERVICES

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

General Provider Information

NPI Number	:	1770442378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVELOPMENTAL THERAPY SERVICES

Provider Business Mailing Address
First Line	:	12230 RILEY LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-4918
Country	:	US
Telephone Number	:	619-454-3849
Fax Number	:

Provider Business Practice Location Address
First Line	:	12230 RILEY LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-4918
Country	:	US
Telephone Number	:	858-663-9127
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MRS. ANGELA DESIDERI
Credential	:	M.S. CCC-SLP
Telephone Number	:	858-663-9127

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “DEVELOPMENTAL THERAPY SERVICES ” Practice Location

Language	Start Address	Practice Location

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