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General NPI Number Information
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NPI Number | 1083347165
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Entity Type | Individual
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Provider Name | NUTTHAGRITA VIVIAN ELLER MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1821 S MILPITAS BLVD
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City | MILPITAS
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State | CA
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Zip | 95035-6318
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Country | US
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Telephone | 415-857-5783
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Fax |
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Provider Business Mailing Address
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Address Line | 455 MARKET ST STE 1940
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-2448
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Country | US
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Telephone |
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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 | 40552
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License Number State | CA
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