Provider Demographics
NPI:1275817751
Name:GRASSO, NOEMI (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:GRASSO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:MANUELA
Other - Last Name:PANCA CHIUCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:16466 BERNARDO CENTER DR STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2529
Mailing Address - Country:US
Mailing Address - Phone:619-480-3243
Mailing Address - Fax:
Practice Address - Street 1:16466 BERNARDO CENTER DR STE 116
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2529
Practice Address - Country:US
Practice Address - Phone:858-521-8446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist