Healthcare Provider Details

I. General information

NPI: 1962087791
Provider Name (Legal Business Name): CARLY SAUNDERS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 B ST
DAVIS CA
95616-3811
US

IV. Provider business mailing address

41555 COOK ST STE 130
PALM DESERT CA
92211-5184
US

V. Phone/Fax

Practice location:
  • Phone: 530-757-5300
  • Fax:
Mailing address:
  • Phone: 760-837-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: