| Mia Theis, | |
|
10305 Promenade Pkwy, Elk Grove, CA 95757-9400 | |
| (916) 688-2000 | |
| Not Available |
| Full Name | Mia Theis |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 10305 Promenade Pkwy, Elk Grove, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699402297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 16719 (California) | Primary |
| Provider Name | Permanente Medical Group Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Mia Theis, 3320 Data Dr Ste 400, Rancho Cordova, CA 95670-7341 Ph: (916) 564-5010 | Mia Theis, 10305 Promenade Pkwy, Elk Grove, CA 95757-9400 Ph: (916) 688-2000 |
Allison Hackett, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 9300 W Stockton Blvd, Elk Grove, CA 95758 Phone: 916-896-1144 |
Angela Soto, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6900 Kilconnell Dr, Elk Grove, CA 95758 Phone: 916-753-4271 |
Neural Pathways Speech Therapy Inc Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8484 Sun Berry Ct, Elk Grove, CA 95624 Phone: 510-857-6554 |
Lisa Ann Harada, M.S., SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 9510 Elk Grove Florin Rd, Elk Grove, CA 95624 Phone: 916-686-5085 |
Heather Marie Wiechert, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 10774 Sheldon Woods Way, Elk Grove, CA 95624 Phone: 209-610-1789 |
Agnes Cuison, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8351 Eastleigh Ct, Elk Grove, CA 95624 Phone: 916-320-7899 |
Kirsten Alexis Konkel, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8788 Elk Grove Blvd, Bldg 3, Suite 12i, Elk Grove, CA 95624 Phone: 916-467-8344 |