MEDICARE: MS. MARINA ANN GAFNI CF-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	235Z00000X	Speech-Language Pathologist	11983	CA

General Provider Information

NPI Number	:	1053885947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARINA ANN GAFNI CF-SLP

Provider Business Mailing Address
First Line	:	6481 SULU CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1936
Country	:	US
Telephone Number	:	415-438-0205
Fax Number	:

Provider Business Practice Location Address
First Line	:	6481 SULU CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1936
Country	:	US
Telephone Number	:	415-438-0205
Fax Number	:

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

Provider Enumeration Date	:	01/14/2019
Last Update Date	:	01/14/2019

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