Basic Information
| Provider Information | |||||||||
| NPI: | 1932647435 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALI | ||||||||
| FirstName: | TASNEEM | ||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PARVAZ | ||||||||
| OtherFirstName: | TASNEEM | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3344 BIEN CT | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951482172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086637907 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 787 MUNRAS AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939403128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316457900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 02/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | RPE 10686 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.