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Organization

OCEANSIDE THERAPY GROUP, INC.

Active
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Organization

OCEANSIDE THERAPY GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. REBEKAH LOUISE VAN ORDEN M.S., CCC-SLP (OWNER/SPEECH-LANGUAGE PATHOLOGIST)
(760) 529-4975
Entity
Organization

Contact information

Practice address
1930 S COAST HWY, 103, OCEANSIDE, CA 92054-6455
(760) 529-4975
(760) 529-4761
Mailing address
1930 S COAST HWY, 103, OCEANSIDE, CA 92054-6455
(760) 529-4975
(760) 529-4761

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP17061
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427186378
INDIVIDUAL NPI NUMBER
CA
05
160476721
AR
Enumeration date
12/17/2009
Last updated
12/17/2009
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