Bibin Chacko
Individual provider Active NPI Speech-Language Pathologist · Patterson, CA
NPI 1932713104 · NPPES record last updated Sep 3, 2020
Key facts
- NPI
- 1932713104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 535 Peregrine Dr
Patterson, CA 95363-8703 - Phone
- (209) 892-4710
- NPI assigned
- Sep 3, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
535 Peregrine Dr
Patterson, CA 95363-8703
Mailing address
1548 Canal Farm LN Apt 6C
Los Banos, CA 93635-4430
Phone (310) 874-7766
Other providers in Patterson, CA
- Amparo Campos
- Ana Carranza Delgado
- Luis Castillo
- Center for Human Services
- Center for Human Services
- Jennifer Lynn Chapman
- Freda Chin
- Carlton Tara Chow
- Andrea Chy
- Jasline Clauzel
All providers in Patterson, 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 Sep 3, 2020. 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.