Healthcare Provider Details

I. General information

NPI: 1194454884
Provider Name (Legal Business Name): HEIDI DELGADO PELAEZ SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E ALVIN AVE
SANTA MARIA CA
93454-3703
US

IV. Provider business mailing address

2490 VILLAGE GRN
SANTA MARIA CA
93455-1681
US

V. Phone/Fax

Practice location:
  • Phone: 805-361-6560
  • Fax:
Mailing address:
  • Phone: 949-413-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: