Individual
DI HSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1440 168TH AVE, SAN LEANDRO, CA 94578-2409
(510) 481-6329
Mailing address
1440 168TH AVE, SAN LEANDRO, CA 94578-2409
(510) 481-6329
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CA 8317
CA
Other
Enumeration date
01/11/2007
Last updated
11/17/2021
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