Provider Demographics
NPI:1053599373
Name:SOCIAL COMMUNICATION SPECIALISTS SPEECH THERAPY CLINIC, APC
Entity type:Organization
Organization Name:SOCIAL COMMUNICATION SPECIALISTS SPEECH THERAPY CLINIC, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULI
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:619-591-9552
Mailing Address - Street 1:2538 CATAMARAN WAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4532
Mailing Address - Country:US
Mailing Address - Phone:619-591-9552
Mailing Address - Fax:
Practice Address - Street 1:2538 CATAMARAN WAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4532
Practice Address - Country:US
Practice Address - Phone:619-591-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14460261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech