Healthcare Provider Details

I. General information

NPI: 1083561815
Provider Name (Legal Business Name): WESTCOAST SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 HAZEL PLACE
COSTA MESA CA
92626
US

IV. Provider business mailing address

2807 HAZEL PLACE
COSTA MESA CA
92626
US

V. Phone/Fax

Practice location:
  • Phone: 310-926-5529
  • Fax:
Mailing address:
  • Phone: 310-926-5529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH TAYLOR
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 310-926-5529