Healthcare Provider Details

I. General information

NPI: 1811802226
Provider Name (Legal Business Name): BEA JAN MARIE GELERA TAPAWAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BEA JAN TAPAWAN

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17802 SKY PARK CIR STE 104
IRVINE CA
92614-6405
US

IV. Provider business mailing address

105 E LEATRICE LN APT B
ANAHEIM CA
92802-4232
US

V. Phone/Fax

Practice location:
  • Phone: 657-448-3366
  • Fax:
Mailing address:
  • Phone: 310-347-7462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: