Provider Demographics
NPI:1164015814
Name:LIM, SAYANG
Entity Type:Individual
Prefix:MRS
First Name:SAYANG
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAYANG
Other - Middle Name:
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3026 NEAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3333
Mailing Address - Country:US
Mailing Address - Phone:408-464-8595
Mailing Address - Fax:
Practice Address - Street 1:229 POLARIS AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4570
Practice Address - Country:US
Practice Address - Phone:650-784-0082
Practice Address - Fax:650-564-0082
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist