Healthcare Provider Details

I. General information

NPI: 1629987292
Provider Name (Legal Business Name): VICTORIA L MACARTHUR M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 PROFESSIONAL CENTER PKWY
SAN RAFAEL CA
94903-2702
US

IV. Provider business mailing address

139 DUNHAM CT
HERCULES CA
94547-3704
US

V. Phone/Fax

Practice location:
  • Phone: 415-479-5161
  • Fax:
Mailing address:
  • Phone: 510-734-9995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: