Provider Demographics
NPI:1730958398
Name:DONG, ALICE GE (MS)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:GE
Last Name:DONG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:DONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:8451 ZINNIA WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4208
Mailing Address - Country:US
Mailing Address - Phone:916-670-4517
Mailing Address - Fax:
Practice Address - Street 1:2715 K ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7189
Practice Address - Country:US
Practice Address - Phone:916-510-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist