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General NPI Number Information
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NPI Number | 1902475106
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Entity Type | Individual
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Provider Name | SANDRA CHAVARRIA M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 15510 USHER ST
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City | SAN LORENZO
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State | CA
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Zip | 94580-1641
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Country | US
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Telephone | 510-852-9105
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Fax |
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Provider Business Mailing Address
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Address Line | SAN LORENZO UNIFIED SCHOOL DISTRICT, SPECIAL SVCS DEPT 15510 USHER STREET
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City | SAN LORENZO
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State | CA
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Zip | 94580
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Country | US
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Telephone | 510-852-9105
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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 | 20286
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License Number State | CA
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