Provider Demographics
NPI:1245803758
Name:TOTAL SPECTRUM THERAPY
Entity Type:Organization
Organization Name:TOTAL SPECTRUM THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PISCITELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-510-8351
Mailing Address - Street 1:7453 WINDBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4703
Mailing Address - Country:US
Mailing Address - Phone:218-750-4319
Mailing Address - Fax:
Practice Address - Street 1:7453 WINDBRIDGE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-4703
Practice Address - Country:US
Practice Address - Phone:218-750-4319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty