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NPI Code Detail

MEDICARE: MIND THE GAP...BRIDGING COMMUNICATION AND MORE

MEDICARE: MIND THE GAP...BRIDGING COMMUNICATION AND MORE
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 Pathologist15024CA

General Provider Information

NPI Number : 1881829778
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND THE GAP...BRIDGING COMMUNICATION AND MORE
Provider Business Mailing Address
First Line : 25115 AVENUE STANFORD
Second Line : SUITE B-121
City : VALENCIA
State : CA
Zip : 91355-1290
Country : US
Telephone Number : 661-295-9696
Fax Number : 661-295-3434
Provider Business Practice Location Address
First Line : 25115 AVENUE STANFORD
Second Line : SUITE B-121
City : VALENCIA
State : CA
Zip : 91355-1290
Country : US
Telephone Number : 661-295-9696
Fax Number : 661-295-3434
Authorized Official
Title or Position : OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name : TIA HERRELL
Credential : M.S.
Telephone Number : 661-295-9696
Provider Enumeration Date : 05/20/2009
Last Update Date : 05/20/2009

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Directions to “MIND THE GAP...BRIDGING COMMUNICATION AND MORE ” 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.