Provider Demographics
NPI:1053040501
Name:PARTH WAYS SPEECH THERAPY PC
Entity Type:Organization
Organization Name:PARTH WAYS SPEECH THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIKKANAYAKANAHALLI
Authorized Official - Middle Name:SWAMYSRIDHARA
Authorized Official - Last Name:SIDDHARTHA
Authorized Official - Suffix:
Authorized Official - Credentials:CCC - SLP, AUD
Authorized Official - Phone:951-215-6042
Mailing Address - Street 1:3330 RURAL CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8382
Mailing Address - Country:US
Mailing Address - Phone:951-215-6042
Mailing Address - Fax:
Practice Address - Street 1:3330 RURAL CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-8382
Practice Address - Country:US
Practice Address - Phone:951-215-6042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty