Basic Information
Provider Information
NPI: 1922340215
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GERRARD
FirstName: ESTHER
MiddleName: HUANG
NamePrefix:  
NameSuffix:  
Credential: MA, CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3350 LA JOLLA VILLAGE DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921610002
CountryCode: US
TelephoneNumber: 8585527564
FaxNumber:  
Practice Location
Address1: 3350 LA JOLLA VILLAGE DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921610002
CountryCode: US
TelephoneNumber: 8585527564
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2013
LastUpdateDate: 05/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X1554NEN Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
235Z00000X17775CAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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