1568774321 NPI number — LANGUAGE ESSENTIALS SPEECH PATHOLOGY, INC.

Table of content: (NPI 1568774321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568774321 NPI number — LANGUAGE ESSENTIALS SPEECH PATHOLOGY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LANGUAGE ESSENTIALS SPEECH PATHOLOGY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LANGUAGE ESSENTIALS, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568774321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 PORTER DR STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN RAMON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94583-1525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-743-3322
Provider Business Mailing Address Fax Number:
925-743-3733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 PORTER DR STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN RAMON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94583-1525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-743-3322
Provider Business Practice Location Address Fax Number:
925-743-3733
Provider Enumeration Date:
07/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
WERNER
Authorized Official First Name:
RENEE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
925-743-3322

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  7221 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com