Healthcare Provider Details

I. General information

NPI: 1326825001
Provider Name (Legal Business Name): SARA ELISA LLAGAS M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E CHASE AVE STE 204
EL CAJON CA
92020-6300
US

IV. Provider business mailing address

10444 ROCK CREEK DR
SAN DIEGO CA
92131-2332
US

V. Phone/Fax

Practice location:
  • Phone: 619-647-6157
  • Fax:
Mailing address:
  • Phone: 858-722-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number34202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: