Provider Demographics
NPI:1295896520
Name:DAWN L HANSEN
Entity type:Organization
Organization Name:DAWN L HANSEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:408-847-7900
Mailing Address - Street 1:662 HAZEL DELL RD
Mailing Address - Street 2:
Mailing Address - City:CORRALITOS
Mailing Address - State:CA
Mailing Address - Zip Code:95076-0313
Mailing Address - Country:US
Mailing Address - Phone:408-847-7900
Mailing Address - Fax:408-847-3757
Practice Address - Street 1:7888 WREN AVE STE C131
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4965
Practice Address - Country:US
Practice Address - Phone:408-847-7900
Practice Address - Fax:408-847-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP5621235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty