Healthcare Provider Details

I. General information

NPI: 1962732487
Provider Name (Legal Business Name): SHEILA M BLOOMER M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2010
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 TULARE ST
FRESNO CA
93721-2205
US

IV. Provider business mailing address

2645 FISHERMAN BAY CT APT 2
BREMERTON WA
98312-6039
US

V. Phone/Fax

Practice location:
  • Phone: 559-457-3000
  • Fax:
Mailing address:
  • Phone: 714-222-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCA 16299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: