MEDICARE: CASSANDRA ECLARINAL

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	2355S0801X	Speech-Language Assistant	SPA 1281	CA

General Provider Information

NPI Number	:	1477868107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA ECLARINAL

Provider Business Mailing Address
First Line	:	2346 SEABRIGHT AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810-3247
Country	:	US
Telephone Number	:	562-841-1361
Fax Number	:

Provider Business Practice Location Address
First Line	:	2346 SEABRIGHT AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810-3247
Country	:	US
Telephone Number	:	562-841-1361
Fax Number	:

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

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	08/18/2010

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Directions to “ CASSANDRA ECLARINAL ” Practice Location

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