MEDICARE: THELMA GARCIA LONG 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	15743	CA

General Provider Information

NPI Number	:	1184710006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THELMA GARCIA LONG SLP

Provider Business Mailing Address
First Line	:	3004 MCGRAW ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6047
Country	:	US
Telephone Number	:	619-708-6610
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 MCGRAW ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-6047
Country	:	US
Telephone Number	:	619-708-6610
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	03/19/2026

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Directions to “ THELMA GARCIA LONG SLP” Practice Location

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