Provider Demographics
NPI:1740635853
Name:EASTHILLS SPEECH-LANGUAGE SERVICES
Entity type:Organization
Organization Name:EASTHILLS SPEECH-LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:661-343-5129
Mailing Address - Street 1:3939 BERNARD ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3168
Mailing Address - Country:US
Mailing Address - Phone:661-230-6230
Mailing Address - Fax:661-234-8895
Practice Address - Street 1:3939 BERNARD ST
Practice Address - Street 2:SUITE 6
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3168
Practice Address - Country:US
Practice Address - Phone:661-230-6230
Practice Address - Fax:661-234-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty