Provider Demographics
NPI:1205608924
Name:OCEANS THERAPY & SPEECH PATHOLOGY, INC.
Entity type:Organization
Organization Name:OCEANS THERAPY & SPEECH PATHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:714-951-1534
Mailing Address - Street 1:412 OLIVE AVE # 177
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5142
Mailing Address - Country:US
Mailing Address - Phone:714-951-1534
Mailing Address - Fax:
Practice Address - Street 1:3420 BRISTOL ST FL 6
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7170
Practice Address - Country:US
Practice Address - Phone:714-794-2034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech