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General NPI Number Information
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NPI Number | 1316676281
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Entity Type | Individual
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Provider Name | IANTE ROY
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 114 N SUNRISE AVE STE B3
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City | ROSEVILLE
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State | CA
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Zip | 95661-2950
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Country | US
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Telephone | 916-671-0954
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Fax |
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Provider Business Mailing Address
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Address Line | 17216 SATICOY ST # 141
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City | VAN NUYS
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State | CA
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Zip | 91406-2103
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Country | US
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Telephone | 818-392-8067
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 6362
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License Number State | CA
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