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NPI Code Detail

MEDICARE: MRS. CHRISTINA GASTELO MS, CCC-SLP

MEDICARE: MRS. CHRISTINA GASTELO MS, CCC-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
1235Z00000XSpeech-Language Pathologist21721CA

General Provider Information

NPI Number : 1174058499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA GASTELO MS, CCC-SLP
Provider Business Mailing Address
First Line : 300 DOUGLAS ST
Second Line :
City : PETALUMA
State : CA
Zip : 94952-2503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 DOUGLAS ST
Second Line :
City : PETALUMA
State : CA
Zip : 94952-2503
Country : US
Telephone Number : 707-763-6887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2017
Last Update Date : 04/24/2017

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Directions to “ MRS. CHRISTINA GASTELO MS, CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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