Basic Information
| Provider Information | |||||||||
| NPI: | 1568529212 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POST SPEECH PATHOLOGY, INC. | ||||||||
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| OtherOrganizationName: | TUSTIN SPEECH AND LANGUAGE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 661 W 1ST ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927802939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148382853 | ||||||||
| FaxNumber: | 7148384533 | ||||||||
| Practice Location | |||||||||
| Address1: | 661 W 1ST ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927802939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148382853 | ||||||||
| FaxNumber: | 7148384533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | POST | ||||||||
| AuthorizedOfficialFirstName: | LORENA | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7148382853 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | SP5043 | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111NR0400X | OT7446 | CA | X | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | Rehabilitation | 235Z00000X | SP5043 | CA | X | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.