Provider Demographics
NPI:1265934855
Name:ROMERO, HOLLY ANN (SLPA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:ROMERO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8660 BRENTWOOD BLVD.
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513
Mailing Address - Country:US
Mailing Address - Phone:925-626-7474
Mailing Address - Fax:
Practice Address - Street 1:8660 BRENTWOOD BLVD.
Practice Address - Street 2:SUITE C
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-9451
Practice Address - Country:US
Practice Address - Phone:925-626-7474
Practice Address - Fax:914-481-7524
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40172355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant