Provider Demographics
NPI:1689055337
Name:CHILDREN'S CHOICE FOR HEARING AND TALKING SACRAMENTO
Entity Type:Organization
Organization Name:CHILDREN'S CHOICE FOR HEARING AND TALKING SACRAMENTO
Other - Org Name:CCHAT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:COVELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A, MED
Authorized Official - Phone:916-361-7290
Mailing Address - Street 1:11100 COLOMA RD
Mailing Address - Street 2:CCHAT CENTER
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2804
Mailing Address - Country:US
Mailing Address - Phone:916-361-7290
Mailing Address - Fax:916-361-8613
Practice Address - Street 1:11100 COLOMA RD
Practice Address - Street 2:CCHAT CENTER
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2804
Practice Address - Country:US
Practice Address - Phone:916-361-7290
Practice Address - Fax:916-361-8613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2323231H00000X
CAAU3122231H00000X
CA22042355S0801X
CA11522355S0801X
CA9854235Z00000X
CA10526235Z00000X
CA8760235Z00000X
CA8808235Z00000X
CA3122237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty