MEDICARE: MRS. CAROLINE KEIGHRAN 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
1	235Z00000X	Speech-Language Pathologist	11624	CA

General Provider Information

NPI Number	:	1871800391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLINE KEIGHRAN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2500 OLD CROW CANYON RD
Second Line	:	BUILDING 100, SUITE 112
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1623
Country	:	US
Telephone Number	:	925-362-0683
Fax Number	:	925-362-0680

Provider Business Practice Location Address
First Line	:	2500 OLD CROW CANYON RD
Second Line	:	BUILDING 100, SUITE 112
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1623
Country	:	US
Telephone Number	:	925-362-0683
Fax Number	:	925-362-0680

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

Provider Enumeration Date	:	09/03/2010
Last Update Date	:	09/03/2010

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Directions to “ MRS. CAROLINE KEIGHRAN M.S., CCC-SLP” Practice Location

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