Doctor Name: | CRYSTAL JEAN BETITO |
NPI Number: | 1407107915 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 19152 |
Business Practice Address: | 3205 Hurley Way Sacramento, CA - 958643853 |
Business Phone Number: | 9164856711 |
Business Fax Number: | 9164852653 |
Mailing Address: | 3205 Hurley Way, SACRAMENTO |
State: | CA |
Postal Code: | 958643853 |
Phone Number: | 9164856711 |
Fax Number: | 9164852653 |
NPI Enumeration Date: | 09/24/2012 |
NPI Last Update Date: | 09/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 19152 |
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 |