Provider Demographics
NPI:1558614883
Name:AYLON, MICHELLE GEFFEN (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GEFFEN
Last Name:AYLON
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3209
Mailing Address - Country:US
Mailing Address - Phone:415-255-9395
Mailing Address - Fax:
Practice Address - Street 1:258 LAGUNA HONDA BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1409
Practice Address - Country:US
Practice Address - Phone:415-702-6009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7653235Z00000X
CA20893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist