Provider Demographics
NPI:1801673967
Name:WEINTRAUB, RONA PHYLLIS (MA SLP)
Entity type:Individual
Prefix:MS
First Name:RONA
Middle Name:PHYLLIS
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:MS
Other - First Name:RONA
Other - Middle Name:P
Other - Last Name:WEINTRAUB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:110 SEMINARY DRIVE
Mailing Address - Street 2:UNIT 3F
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3176
Mailing Address - Country:US
Mailing Address - Phone:415-328-3138
Mailing Address - Fax:
Practice Address - Street 1:110 SEMINARY DRIVE
Practice Address - Street 2:UNIT 3F
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3176
Practice Address - Country:US
Practice Address - Phone:415-388-7598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist