MEDICARE: EVA ACEVEDO

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	2355S0801X	Speech-Language Assistant	9616	CA

General Provider Information

NPI Number	:	1962392647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA ACEVEDO

Provider Business Mailing Address
First Line	:	1145 PENN AVE
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-1330
Country	:	US
Telephone Number	:	209-620-7948
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 OAKDALE RD STE 1110
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95355-3361
Country	:	US
Telephone Number	:	209-353-2890
Fax Number	:

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

Provider Enumeration Date	:	07/05/2025
Last Update Date	:	07/05/2025

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Directions to “ EVA ACEVEDO ” Practice Location

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