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General NPI Number Information
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NPI Number | 1821561085
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Entity Type | Organization
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Legal Business Name | PENGUINSMART INC.
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 2121 CORONET BLVD
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City | BELMONT
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State | CA
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Zip | 94002-1663
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Country | US
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Telephone | 650-691-5723
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 CORONET BLVD
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City | BELMONT
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State | CA
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Zip | 94002-1663
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Country | US
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Telephone | 650-691-5723
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MR. MATTHEW KWOK
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Credential |
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Telephone | 650-691-5723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QA3000X
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Taxonomy Name | Augmentative Communication Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #10
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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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