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General NPI Number Information
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NPI Number | 1376042226
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Entity Type | Organization
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Legal Business Name | SOCIAL BUTTERFLY SPEECH LANGUAGE PATHOLOGY
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 32145 ALVARADO NILES RD STE 201
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City | UNION CITY
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State | CA
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Zip | 94587-2930
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Country | US
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Telephone | 510-501-4044
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Fax | 510-501-4044
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Provider Business Mailing Address
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Address Line | 32484 DEBORAH DR
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City | UNION CITY
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State | CA
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Zip | 94587-5007
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Country | US
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Telephone | 510-501-4044
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. BONNIE GOCE-CAMAT
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Credential | M.S, CCC-SLP
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Telephone | 510-501-4044
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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 | 16119
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License Number State | CA
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