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Organization
SKY PEDIATRIC, INC.
Active
Organization
SKY PEDIATRIC, INC.
Active
Other names
SKY Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN LUNDBLADE (ADMINISTRATOR)
(949) 797-9007
Entity
Organization
Contact information
Practice address
1929 MAIN ST, #103, IRVINE, CA 92614-0509
(949) 797-9007
(949) 797-9234
Mailing address
1929 MAIN ST, #103, IRVINE, CA 92614-0509
(949) 797-9007
(949) 797-9234
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ36141Z
BLUE SHIELD
CA
01
—
ZZZ65557Z
BLUE SHIELD
CA
Enumeration date
01/26/2006
Last updated
09/11/2025
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