Provider Demographics
NPI:1356589022
Name:CENTRAL COAST LANGUAGE AND LEARNING CENTER
Entity type:Organization
Organization Name:CENTRAL COAST LANGUAGE AND LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPEECH AND LANGUAGE
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:D'ATTILIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:831-645-7900
Mailing Address - Street 1:787 MUNRAS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-645-7900
Mailing Address - Fax:831-645-7906
Practice Address - Street 1:787 MUNRAS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3128
Practice Address - Country:US
Practice Address - Phone:831-645-7900
Practice Address - Fax:831-645-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13025252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency