Healthcare Provider Details

I. General information

NPI: 1245111012
Provider Name (Legal Business Name): FIRST EXPRESSIONS SPEECH-LANGUAGE PATHOLOGY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6370 MAGNOLIA AVE STE 200
RIVERSIDE CA
92506-2406
US

IV. Provider business mailing address

6370 MAGNOLIA AVE STE 200
RIVERSIDE CA
92506-2406
US

V. Phone/Fax

Practice location:
  • Phone: 951-587-6973
  • Fax:
Mailing address:
  • Phone: 951-587-6973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: JULIA VAZQUEZ
Title or Position: SPEECH-LANGUAGE PATHOLOGY ASSISTANT
Credential:
Phone: 951-587-6973