Healthcare Provider Details

I. General information

NPI: 1346164456
Provider Name (Legal Business Name): ANNE VIOLA DULAY-THAO MS, CCC-SLP
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ANNE AUBREY VIOLA DULAY-THAO

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ALAMEDA DE LAS PULGAS
SAN MATEO CA
94402-3358
US

IV. Provider business mailing address

1008 PALM AVE
SAN MATEO CA
94401-4334
US

V. Phone/Fax

Practice location:
  • Phone: 650-312-7511
  • Fax:
Mailing address:
  • Phone: 707-439-1915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number35573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: