Healthcare Provider Details

I. General information

NPI: 1447643085
Provider Name (Legal Business Name): CELEBRATIONS SPEECH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SAND CREEK RD STE G4
BRENTWOOD CA
94513-2124
US

IV. Provider business mailing address

PO BOX 165
BRENTWOOD CA
94513-0165
US

V. Phone/Fax

Practice location:
  • Phone: 925-759-6519
  • Fax:
Mailing address:
  • Phone: 925-759-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHIMEZIE CHIDI
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 925-759-6519