=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609341189
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH ELIZABETH GARIEPY MS CF-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2018
-----------------------------------------------------
Last Update Date | 10/10/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39375 CEDAR BLVD
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94560-5003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-818-4316
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 N WHISMAN RD APT 2626
-----------------------------------------------------
City | MOUNTAIN VIEW
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94043-4922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-686-8876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 12975
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------