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General NPI Number Information
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NPI Number | 1629630090
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Entity Type | Individual
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Provider Name | SORAYA CLEARY
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Gender | Female
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 07/05/2019
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Provider Practice Location Address
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Address Line | 41421 DATE ST STE 101
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City | MURRIETA
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State | CA
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Zip | 92562-7079
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Country | US
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Telephone | 855-469-7275
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Fax |
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Provider Business Mailing Address
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Address Line | 31161 OLD TRAIL CIR
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City | MURRIETA
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State | CA
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Zip | 92563-6272
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Country | US
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Telephone | 619-302-7828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 16202
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License Number State | CA
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