Provider Demographics
NPI:1437936408
Name:COASTAL VALLEY COMMUNICATION THERAPY INC.
Entity type:Organization
Organization Name:COASTAL VALLEY COMMUNICATION THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCC-SLP
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVERENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:805-575-7812
Mailing Address - Street 1:8605 SANTA MONICA BLVD
Mailing Address - Street 2:PMB 320298
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069
Mailing Address - Country:US
Mailing Address - Phone:262-804-2200
Mailing Address - Fax:
Practice Address - Street 1:2660 PENINSULA RD APT 165
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-4016
Practice Address - Country:US
Practice Address - Phone:805-575-7812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty