Healthcare Provider Details

I. General information

NPI: 1790607695
Provider Name (Legal Business Name): GOLDEN COAST SPEECH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W BROADWAY STE 3-114
LONG BEACH CA
90802-4431
US

IV. Provider business mailing address

3901 E 11TH ST APT 7
LONG BEACH CA
90804-6778
US

V. Phone/Fax

Practice location:
  • Phone: 661-471-0238
  • Fax:
Mailing address:
  • Phone: 661-471-0238
  • 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: KAILIE RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 661-471-0238