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General NPI Number Information
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NPI Number | 1093038846
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Entity Type | Individual
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Provider Name | AMBER ELIZABETH DINICOLA M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 163 ENCANTADO CYN
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2985
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Country | US
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Telephone | 949-412-7152
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 BARRANCA PKWY
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City | IRVINE
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State | CA
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Zip | 92604-4652
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Country | US
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Telephone | 949-936-8564
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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 | SP18252
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License Number State | CA
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