Healthcare Provider Details

I. General information

NPI: 1710712419
Provider Name (Legal Business Name): ESPERANZA SPEECH THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 BALLAST AVE
GARDEN GROVE CA
92843-5308
US

IV. Provider business mailing address

10601 BALLAST AVE
GARDEN GROVE CA
92843-5308
US

V. Phone/Fax

Practice location:
  • Phone: 714-253-4083
  • Fax:
Mailing address:
  • Phone: 714-253-4083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CINDY RODRIGUEZ
Title or Position: PRESIDENT/SPEECHLANGUAGEPATHOLOGIST
Credential:
Phone: 714-253-4083