Provider Demographics
NPI:1033456132
Name:SOUTH COUNTY PEDIATRIC SPEECH
Entity Type:Organization
Organization Name:SOUTH COUNTY PEDIATRIC SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-367-8150
Mailing Address - Street 1:26400 LA ALAMEDA
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6318
Mailing Address - Country:US
Mailing Address - Phone:949-367-8150
Mailing Address - Fax:949-367-8154
Practice Address - Street 1:26400 LA ALAMEDA
Practice Address - Street 2:SUITE 107
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6318
Practice Address - Country:US
Practice Address - Phone:949-367-8150
Practice Address - Fax:949-367-8154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty