Provider Demographics
NPI:1093277311
Name:4 OAKS, INC
Entity Type:Organization
Organization Name:4 OAKS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:818-292-5335
Mailing Address - Street 1:362 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1150
Mailing Address - Country:US
Mailing Address - Phone:818-292-5335
Mailing Address - Fax:
Practice Address - Street 1:5655 LINDERO CANYON RD STE 106-5
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4016
Practice Address - Country:US
Practice Address - Phone:818-292-5335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94134OtherKAISER (SOUTHERN CALIFORNIA ONLY) PERMANENTE