Healthcare Provider Details

I. General information

NPI: 1023949443
Provider Name (Legal Business Name): GRACE NEUMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 NAPLES ST
CHULA VISTA CA
91911-1619
US

IV. Provider business mailing address

11019 LOGAN WAY
SAN DIEGO CA
92129-2080
US

V. Phone/Fax

Practice location:
  • Phone: 619-422-8369
  • Fax:
Mailing address:
  • Phone: 858-945-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22968
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: