Individual
ISABEL FORMOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
9005 ALCOSTA BLVD APT 215, SAN RAMON, CA 94583-4044
(347) 610-2433
Mailing address
6705 SKYVIEW DR, OAKLAND, CA 94605-3137
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
27708
CA
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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