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General NPI Number Information
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NPI Number | 1720334717
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Entity Type | Organization
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Legal Business Name | SF SPEECH THERAPY FOR KIDS INC
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Dates
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Enumeration Date | 07/27/2012
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 525 IRVING ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2599
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Country | US
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Telephone | 415-218-3506
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Fax | 866-491-5994
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Provider Business Mailing Address
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Address Line | 525 IRVING ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2599
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Country | US
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Telephone | 415-218-3506
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Fax | 866-491-5994
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | KIMBERLY ANNE CHRISTENSEN
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Credential | M.S., CCC
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Telephone | 415-218-3506
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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 | 17101
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License Number State | CA
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