| Organization Name: | SANTA ROSA SPEECH & LANGUAGE SERVICES |
| NPI Number: | 1992781421 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN MAR SAMPLES (OWNER) |
| Mailing Address: | 4725b Hoen Ave Santa Rosa |
| State: | CA US |
| Postal Code: | 954057862 |
| Phone Number: | 7075421010 |
| Fax Number: | 7075424818 |
| NPI Enumeration Date: | 12/16/2005 |
| NPI Last Update Date: | 07/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP1429 |
| 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 |