Provider Demographics
NPI:1871800391
Name:KEIGHRAN, CAROLINE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:KEIGHRAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 OLD CROW CANYON RD
Mailing Address - Street 2:BUILDING 100, SUITE 112
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1623
Mailing Address - Country:US
Mailing Address - Phone:925-362-0683
Mailing Address - Fax:925-362-0680
Practice Address - Street 1:2500 OLD CROW CANYON RD
Practice Address - Street 2:BUILDING 100, SUITE 112
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1623
Practice Address - Country:US
Practice Address - Phone:925-362-0683
Practice Address - Fax:925-362-0680
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist