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General NPI Number Information
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NPI Number | 1316810328
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Entity Type | Organization
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Legal Business Name | CONSCIOUS KIDS SPEECH
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 16430 BAKE PKWY
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City | IRVINE
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State | CA
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Zip | 92618-4665
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Country | US
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Telephone | 714-767-4495
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Fax | 949-271-2310
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Provider Business Mailing Address
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Address Line | 16430 BAKE PKWY
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City | IRVINE
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State | CA
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Zip | 92618-4665
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Country | US
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Telephone | 714-767-4495
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Fax | 949-271-2310
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Authorized Official
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Title or Position | FINANCE MANAGER
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Name | AVERY ENCARNACION
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Credential |
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Telephone | 714-388-0474
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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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