Provider Demographics
NPI:1891347647
Name:WALTMAN, YAHDIRA
Entity Type:Individual
Prefix:MS
First Name:YAHDIRA
Middle Name:
Last Name:WALTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 SANTA RITA RD STE 112
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4741
Mailing Address - Country:US
Mailing Address - Phone:925-478-6217
Mailing Address - Fax:
Practice Address - Street 1:1811 SANTA RITA RD STE 112
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4741
Practice Address - Country:US
Practice Address - Phone:925-478-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA30122355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant