Provider Demographics
NPI:1588120646
Name:POMPAY, DEBRA WIESLER
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:WIESLER
Last Name:POMPAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FESTIVO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8908
Mailing Address - Country:US
Mailing Address - Phone:949-922-0737
Mailing Address - Fax:
Practice Address - Street 1:55 FESTIVO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8908
Practice Address - Country:US
Practice Address - Phone:949-922-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist