1275730962 NPI number — MS. HOPE ANN ROBERTSHAW MA, C.C.C.SLP 14410

Table of content: MS. HOPE ANN ROBERTSHAW MA, C.C.C.SLP 14410 (NPI 1275730962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275730962 NPI number — MS. HOPE ANN ROBERTSHAW MA, C.C.C.SLP 14410

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBERTSHAW
Provider First Name:
HOPE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, C.C.C.SLP 14410
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1275730962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4744 LA CRESCENTA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA CRESCENTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91214-2937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-249-4774
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13400 RIVERSIDE DR
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
SHERMAN OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91423-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-783-5168
Provider Business Practice Location Address Fax Number:
515-783-6176
Provider Enumeration Date:
06/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP 14410 , 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)





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