Provider Demographics
NPI:1801513585
Name:SENSATIONAL KIDZ SPEECH THERAPY, INC.
Entity type:Organization
Organization Name:SENSATIONAL KIDZ SPEECH THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIDEM
Authorized Official - Middle Name:YILMAZ
Authorized Official - Last Name:MCCOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:949-378-5157
Mailing Address - Street 1:1948 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4407
Mailing Address - Country:US
Mailing Address - Phone:949-378-5157
Mailing Address - Fax:628-270-9922
Practice Address - Street 1:3100 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4046
Practice Address - Country:US
Practice Address - Phone:415-699-4128
Practice Address - Fax:628-270-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty