Healthcare Provider Details

I. General information

NPI: 1457135725
Provider Name (Legal Business Name): ARI SEPULVEDA M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 DOHR ST
BERKELEY CA
94702-2713
US

IV. Provider business mailing address

3041 DOHR ST
BERKELEY CA
94702-2713
US

V. Phone/Fax

Practice location:
  • Phone: 541-780-4160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: