Provider Demographics
NPI:1538529938
Name:COMMUNICATION STATION, INC
Entity type:Organization
Organization Name:COMMUNICATION STATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERMRECK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:209-505-8321
Mailing Address - Street 1:4605 VIA GIARDIANO
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-0661
Mailing Address - Country:US
Mailing Address - Phone:209-505-8321
Mailing Address - Fax:209-551-5407
Practice Address - Street 1:4605 VIA GIARDIANO
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95357-0661
Practice Address - Country:US
Practice Address - Phone:209-505-8321
Practice Address - Fax:209-551-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16085235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty