Lisa Amavisca, M.S. – Speech-Language Pathologist

Key facts

NPI: 1720126428
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: RPE4222 (CA)
Practice address: 750 F St Ste 2
Davis, CA 95616-3738
Phone: (530) 758-8944
Fax: (530) 758-4302
NPI assigned: Feb 2, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Center for Speech Pathology, Inc. a Professional Corporation Speech-Language Pathologist · Davis, CA · NPI 1972656676

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
RPE4222	CA	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Center for Speech Pathology, Inc. a Professional Corporation	Speech-Language Pathologist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	RPE4222	CA	Yes

Addresses

Primary practice location

750 F St Ste 2
Davis, CA 95616-3738

Mailing address

2955 Leonor Dr
Sacramento, CA 95833-2801
Phone (916) 359-2752

Other providers in Davis, CA

All providers in Davis, CA · Speech-Language Pathologist in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.