Provider Demographics
NPI:1447827084
Name:WHITMARSH, ARIANA GRACE (CF-SLP)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:GRACE
Last Name:WHITMARSH
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 WALNUT SHADOWS CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3568
Mailing Address - Country:US
Mailing Address - Phone:925-899-2962
Mailing Address - Fax:
Practice Address - Street 1:3806 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2516
Practice Address - Country:US
Practice Address - Phone:925-689-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
CA15622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CCV207M87277OtherBLUE ANTHEM