Healthcare Provider Details
I. General information
NPI: 1497600142
Provider Name (Legal Business Name): JOSEPH CARLTON HITCHCOCK SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/27/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
450 SUTTER ST RM 933
SAN FRANCISCO CA
94108-3997
US
IV. Provider business mailing address
911 W 4TH ST
ROYAL OAK MI
48067-2469
US
V. Phone/Fax
- Phone: 415-362-5443
- Fax: 415-362-5444
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SLP42086 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 7152001199 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: