Provider Demographics
NPI:1942861919
Name:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Entity Type:Organization
Organization Name:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other - Org Name:PROVIDENCE SPEECH AND HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC. VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-509-8451
Mailing Address - Street 1:1201 W LA VETA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 W PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3808
Practice Address - Country:US
Practice Address - Phone:714-639-4990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-21
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty