Provider Demographics
NPI:1013723543
Name:SPEECH BLOOM LANGUAGE PATHOLOGY INC.
Entity type:Organization
Organization Name:SPEECH BLOOM LANGUAGE PATHOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMITRIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-337-9169
Mailing Address - Street 1:555 PETERS AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6595
Mailing Address - Country:US
Mailing Address - Phone:925-337-9169
Mailing Address - Fax:
Practice Address - Street 1:555 PETERS AVE STE 110
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6595
Practice Address - Country:US
Practice Address - Phone:925-337-9169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty