Basic Information
| Provider Information | |||||||||
| NPI: | 1518490549 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHOLEH SHAHINFAR, SPEECH LANGUAGE PATHOLOGY INC | ||||||||
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| OtherOrganizationName: | VALUED VOICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3300 IRVINE AVE | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926603109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2408764855 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3300 IRVINE AVE | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926603109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2408764855 | ||||||||
| FaxNumber: | 9492509485 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2017 | ||||||||
| LastUpdateDate: | 04/06/2017 | ||||||||
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| AuthorizedOfficialLastName: | SHAHINFAR | ||||||||
| AuthorizedOfficialFirstName: | SHOLEH | ||||||||
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| AuthorizedOfficialTitleorPosition: | FOUNDER/SPEECH LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 2408764855 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MA. CCC-SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 18481 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.