MEDICARE: EAST BAY SPEECH PATHOLOGY INC.

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

General Provider Information

NPI Number	:	1558290510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST BAY SPEECH PATHOLOGY INC.

Provider Business Mailing Address
First Line	:	160 ALAMO PLZ UNIT 954
Second Line	:
City	:	ALAMO
State	:	CA
Zip	:	94507-4055
Country	:	US
Telephone Number	:	510-914-0995
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 ALAMO PLZ UNIT 954
Second Line	:
City	:	ALAMO
State	:	CA
Zip	:	94507-4055
Country	:	US
Telephone Number	:	510-914-0995
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LAURIE E AMADOR
Credential	:	MS, CCC-SLP
Telephone Number	:	510-914-0995

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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