Healthcare Provider Details

I. General information

NPI: 1700499449
Provider Name (Legal Business Name): MARIA CHRISTINA DEBARTOLO MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 ARROYO CIR
GILROY CA
95020-7313
US

IV. Provider business mailing address

595 RISSO CT
SANTA CRUZ CA
95062-4938
US

V. Phone/Fax

Practice location:
  • Phone: 669-205-4000
  • Fax:
Mailing address:
  • Phone: 408-623-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: