Provider Demographics
NPI:1740931666
Name:SAMPAGUITA SPEECH THERAPY
Entity type:Organization
Organization Name:SAMPAGUITA SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KHARYL ANNE
Authorized Official - Middle Name:BUGAOISAN
Authorized Official - Last Name:PIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:510-224-3699
Mailing Address - Street 1:25139 ANGELINA LN
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2490
Mailing Address - Country:US
Mailing Address - Phone:916-792-9054
Mailing Address - Fax:
Practice Address - Street 1:25139 ANGELINA LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-2490
Practice Address - Country:US
Practice Address - Phone:916-792-9054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty