Provider Demographics
NPI:1902668411
Name:SPARROW, MEGAN ALEXIS
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALEXIS
Last Name:SPARROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 YGNACIO VALLEY RD STE B212
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8209
Mailing Address - Country:US
Mailing Address - Phone:510-250-9199
Mailing Address - Fax:
Practice Address - Street 1:675 YGNACIO VALLEY RD STE B212
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8209
Practice Address - Country:US
Practice Address - Phone:510-250-9199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84072355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant