Individual
HOLLY RIANNE NAKATA-VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 906-4623
(619) 906-4564
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 906-4623
(619) 906-4564
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
23898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23898
LIC
CA
Enumeration date
03/22/2016
Last updated
03/22/2016
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