Healthcare Provider Details

I. General information

NPI: 1154167310
Provider Name (Legal Business Name): N&J SPEECH THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2024
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 ROSEMEAD BLVD APARTMENT 123
PICO RIVERA CA
90660-1749
US

IV. Provider business mailing address

4200 ROSEMEAD BLVD APT 123
PICO RIVERA CA
90660
US

V. Phone/Fax

Practice location:
  • Phone: 562-303-6552
  • Fax:
Mailing address:
  • Phone: 562-303-6552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIA CANIZAL
Title or Position: OWNER
Credential: M.S., CCC-SLP
Phone: 562-303-6552