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General NPI Number Information
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NPI Number | 1962054015
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Entity Type | Organization
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Legal Business Name | OO SPEECH PATHOLOGY CA, P.C.
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 1720 S AMPHLETT BLVD STE 110
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City | SAN MATEO
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State | CA
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Zip | 94402-2710
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Country | US
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Telephone | 650-931-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 S AMPHLETT BLVD STE 110
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City | SAN MATEO
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State | CA
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Zip | 94402-2710
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JONATHAN WRIGHT
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Credential |
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Telephone | 650-931-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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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 | 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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