Provider Demographics
NPI:1851795132
Name:VAYNSHTOK, JOANNA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:VAYNSHTOK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:VAYNSHTOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:251 RHODE ISLAND ST STE 101
Mailing Address - Street 2:(415) 364-8774
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-5168
Mailing Address - Country:US
Mailing Address - Phone:415-364-8774
Mailing Address - Fax:
Practice Address - Street 1:251 RHODE ISLAND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5168
Practice Address - Country:US
Practice Address - Phone:415-364-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist