Provider Demographics
NPI:1447399282
Name:CALIFORNIA SPEECH & REHABILITATION, INC.
Entity Type:Organization
Organization Name:CALIFORNIA SPEECH & REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST-ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:805-495-3318
Mailing Address - Street 1:505 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-6008
Mailing Address - Country:US
Mailing Address - Phone:805-495-3318
Mailing Address - Fax:
Practice Address - Street 1:505 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6008
Practice Address - Country:US
Practice Address - Phone:805-495-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty