Provider Demographics
NPI:1841481959
Name:CHOMAK, JOAN (MS, CCC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:CHOMAK
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ALTARINDA RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2600
Mailing Address - Country:US
Mailing Address - Phone:925-253-7838
Mailing Address - Fax:925-253-7877
Practice Address - Street 1:23 ALTARINDA RD
Practice Address - Street 2:SUITE 212
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2600
Practice Address - Country:US
Practice Address - Phone:925-253-7838
Practice Address - Fax:925-253-7877
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASLP5090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist