Healthcare Provider Details

I. General information

NPI: 1598674061
Provider Name (Legal Business Name): SERGIO RODRIGO PALZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 CHESS DR
FOSTER CITY CA
94404-1107
US

IV. Provider business mailing address

3233 CASA DE CAMPO APT 3
SAN MATEO CA
94403-3028
US

V. Phone/Fax

Practice location:
  • Phone: 650-312-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: