Healthcare Provider Details
I. General information
NPI: 1164338828
Provider Name (Legal Business Name): CARYN IWAKIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
819 W IOWA AVE
SUNNYVALE CA
94086-5926
US
IV. Provider business mailing address
819 W IOWA AVE
SUNNYVALE CA
94086-5926
US
V. Phone/Fax
- Phone: 408-522-8200
- Fax:
- Phone: 408-522-8200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 41925 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: