Healthcare Provider Details

I. General information

NPI: 1669201588
Provider Name (Legal Business Name): INCLUSION SPEECH THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SHAW AVE STE 101
CLOVIS CA
93612-3819
US

IV. Provider business mailing address

3066 PORTALS AVE
CLOVIS CA
93619-9380
US

V. Phone/Fax

Practice location:
  • Phone: 559-545-1170
  • Fax: 559-272-0235
Mailing address:
  • Phone: 559-779-6390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MELISSA BERTAO
Title or Position: CEO
Credential: M.A.
Phone: 559-779-6390