Provider Demographics
NPI:1669606182
Name:THE LEARNING FOUNTAIN, INC.
Entity type:Organization
Organization Name:THE LEARNING FOUNTAIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUFROCINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALONGA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, SWC
Authorized Official - Phone:925-264-9810
Mailing Address - Street 1:2819 CROW CANYON RD
Mailing Address - Street 2:# 205
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1655
Mailing Address - Country:US
Mailing Address - Phone:925-264-9810
Mailing Address - Fax:925-263-1906
Practice Address - Street 1:2819 CROW CANYON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1655
Practice Address - Country:US
Practice Address - Phone:925-264-9810
Practice Address - Fax:925-263-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 401225XF0002X, 225XP0200X
CAOT401225X00000X
CASP 15247235Z00000X
CAPT80712251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty