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General NPI Number Information
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NPI Number | 1053985648
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Entity Type | Individual
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Provider Name | KRISTINA TAN CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 3400 ALTA ARDEN EXPY
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City | SACRAMENTO
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State | CA
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Zip | 95825-2103
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Country | US
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Telephone | 916-481-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 5634 OWENS DR APT 104
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City | PLEASANTON
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State | CA
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Zip | 94588-3099
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Country | US
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Telephone | 925-399-2331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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