Provider Demographics
NPI:1043729403
Name:SPEECH TIME
Entity Type:Organization
Organization Name:SPEECH TIME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PAITSAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAMKOCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-522-5651
Mailing Address - Street 1:12435 NUGENT DR
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1534
Mailing Address - Country:US
Mailing Address - Phone:818-522-9220
Mailing Address - Fax:
Practice Address - Street 1:2101 N GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2828
Practice Address - Country:US
Practice Address - Phone:818-522-5651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty