| Organization Name: | EASTER SEALS SUPERIOR CALIFORNIA |
| NPI Number: | 1538568977 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENEE WIBBERLEY (A/R SPECIALIST II) |
| Mailing Address: | 3205 Hurley Way Sacramento |
| State: | CA US |
| Postal Code: | 958643853 |
| Phone Number: | 9166793108 |
| Fax Number: | 9164852653 |
| NPI Enumeration Date: | 08/21/2014 |
| NPI Last Update Date: | 08/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 21514 |
| 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 |