Provider Demographics
NPI:1801538350
Name:GROSS, SARAH BROOKE (SLPD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BROOKE
Last Name:GROSS
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2657 IVANHOE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2602
Mailing Address - Country:US
Mailing Address - Phone:818-590-9666
Mailing Address - Fax:
Practice Address - Street 1:3637 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5761
Practice Address - Country:US
Practice Address - Phone:323-906-7360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist