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General NPI Number Information
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NPI Number | 1518764166
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Entity Type | Organization
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Legal Business Name | BRANCHING TREE SPEECH THERAPY
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 6131 ORANGETHORPE AVE STE 180A
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City | BUENA PARK
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State | CA
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Zip | 90620-4901
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Country | US
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Telephone | 562-544-7508
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Fax |
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Provider Business Mailing Address
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Address Line | 19216 NESTOR AVE
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City | CARSON
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State | CA
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Zip | 90746-2606
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Country | US
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Telephone | 562-544-7508
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VERENICE O MEZA
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Credential |
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Telephone | 562-544-7508
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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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