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Organization

SPEECH LANGUAGE PATHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINE SWITZER MA (OWNER, SPEECH PATHOLOGIST)
(714) 544-1860
Entity
Organization

Contact information

Practice address
12791 NEWPORT AVE, SUITE 101, TUSTIN, CA 92780-2751
(714) 544-1860
(714) 730-5372
Mailing address
12791 NEWPORT AVE, SUITE 101, TUSTIN, CA 92780-2751
(714) 544-1860

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SP 3165
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0031650
BLUE SHIELD
CA
01
SP31650
BLUE CROSS
CA
Enumeration date
04/18/2007
Last updated
06/30/2008
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