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NPI Code Detail

MEDICARE: JOSEPH PETRUZZI M.S., CCC-SLP

MEDICARE: JOSEPH PETRUZZI M.S., 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 Pathologist28348CA

General Provider Information

NPI Number : 1841842259
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH PETRUZZI M.S., CCC-SLP
Provider Business Mailing Address
First Line : 2741 RIVERSIDE BLVD STE 2
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-2900
Country : US
Telephone Number : 916-426-6005
Fax Number :
Provider Business Practice Location Address
First Line : 2741 RIVERSIDE BLVD STE 2
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-2900
Country : US
Telephone Number : 916-426-6005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2019
Last Update Date : 07/15/2019

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Directions to “ JOSEPH PETRUZZI M.S., CCC-SLP” Practice Location

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