Provider Demographics
NPI:1477233856
Name:SPEECH TREE THERAPY CENTER
Entity Type:Organization
Organization Name:SPEECH TREE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-383-9104
Mailing Address - Street 1:4010 PORTE LA PAZ UNIT 65
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1997
Mailing Address - Country:US
Mailing Address - Phone:808-383-9104
Mailing Address - Fax:
Practice Address - Street 1:2060 OTAY LAKES RD STE 270
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-1364
Practice Address - Country:US
Practice Address - Phone:808-383-9104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty