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Organization
EASTER SEAL SOCIETY OF SUPERIOR CALIFORNIA
Active
Organization
EASTER SEAL SOCIETY OF SUPERIOR CALIFORNIA
Active
Other names
Easter Seals Superior California
Organization subpart
No
Provider details
NPI number
Authorized official
HOAN NGUYEN (CFO)
(916) 485-6711
Entity
Organization
Contact information
Practice address
7273 MURRAY DR STE 1, STOCKTON, CA 95210-3385
(209) 957-3625
(209) 957-6031
Mailing address
3205 HURLEY WAY, SACRAMENTO, CA 95864-3853
(916) 485-6711
(916) 485-2653
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
NULL
Other
Enumeration date
01/26/2012
Last updated
12/07/2018
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