Doctor Name: | GERALDINE FABELLA |
NPI Number: | 1699079525 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 10776 |
Business Practice Address: | 2876 Carmel St Apt 2 Oakland, CA - 946023461 |
Business Phone Number: | 5106847659 |
Business Fax Number: | |
Mailing Address: | 2876 Carmel St Apt 2, OAKLAND |
State: | CA |
Postal Code: | 946023461 |
Phone Number: | 5106847659 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2011 |
NPI Last Update Date: | 09/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 10776 |
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 |