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General NPI Number Information
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NPI Number | 1609237882
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Entity Type | Organization
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Legal Business Name | SAN FRANCISCO SPEECH-LANGUAGE PATHOLOGY, INC
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 3401 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-5419
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Country | US
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Telephone | 415-496-6757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 318003
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-8003
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Country | US
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Telephone | 415-496-6757
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | BAILEY VENKATRAMAN LEVIS
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Credential | CCC-SLP
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Telephone | 415-496-6757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SP20591
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License Number State |
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