Doctor Name: | VIVIAN THUY PEDERSON |
NPI Number: | 1144609439 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CF-SLP |
License Number: | RPE9733 |
Business Practice Address: | 16782 Von Karman Ave Ste 11 Irvine, CA - 926062417 |
Business Phone Number: | 9495601098 |
Business Fax Number: | |
Mailing Address: | 4701 Garden Pl, YORBA LINDA |
State: | CA |
Postal Code: | 928863406 |
Phone Number: | 7143908092 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2015 |
NPI Last Update Date: | 05/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | RPE9733 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |