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NPI Code Detail

MEDICARE: SPEECH PATHOLOGY ASSOCIATES

MEDICARE: SPEECH PATHOLOGY ASSOCIATES
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 PathologistSP3260CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710260179
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECH PATHOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : 4010 BARRANCA PKWY STE 220
Second Line :
City : IRVINE
State : CA
Zip : 92604-1721
Country : US
Telephone Number : 949-857-6051
Fax Number : 949-857-0941
Provider Business Practice Location Address
First Line : 4010 BARRANCA PKWY STE 220
Second Line :
City : IRVINE
State : CA
Zip : 92604-1721
Country : US
Telephone Number : 949-857-6051
Fax Number : 949-857-0941
Authorized Official
Title or Position : OWNER
Name : MRS. BARBARA C MOORE
Credential : CCC-SLP
Telephone Number : 949-857-6051
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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Directions to “SPEECH PATHOLOGY ASSOCIATES ” 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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