MEDICARE: SOFIA MARINAC SCHILTZ SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	235Z00000X	Speech-Language Pathologist	15697	CA
3	235Z00000X	Speech-Language Pathologist	33450	CA

General Provider Information

NPI Number	:	1023661030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIA MARINAC SCHILTZ SLP

Provider Business Mailing Address
First Line	:	200 GREGORY LN # C202
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-3353
Country	:	US
Telephone Number	:	925-465-6445
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 GREGORY LN # C202
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-3353
Country	:	US
Telephone Number	:	925-465-6445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2019
Last Update Date	:	05/13/2025

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