Provider Demographics
NPI:1346823325
Name:BAKERSFIELD SPEECH THERAPY INC
Entity Type:Organization
Organization Name:BAKERSFIELD SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIDYARANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMURAILATPAM
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:661-631-2229
Mailing Address - Street 1:2205 GAMBEL OAK WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1690
Mailing Address - Country:US
Mailing Address - Phone:661-631-2229
Mailing Address - Fax:661-742-1644
Practice Address - Street 1:4550 PANAMA LN STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-3486
Practice Address - Country:US
Practice Address - Phone:818-943-0704
Practice Address - Fax:661-742-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty