Provider Demographics
NPI:1720891633
Name:LA PEDIATRIC FEEDING AND SPEECH THERAPY INC
Entity type:Organization
Organization Name:LA PEDIATRIC FEEDING AND SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, SLP
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD, CCC-SLP, CLC
Authorized Official - Phone:310-866-8127
Mailing Address - Street 1:16350 VENTURA BLVD STE D173
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-5300
Mailing Address - Country:US
Mailing Address - Phone:310-866-8127
Mailing Address - Fax:
Practice Address - Street 1:4933 PETIT AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1130
Practice Address - Country:US
Practice Address - Phone:310-866-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech