Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

San Diego State University

Organization Speech-Language Pathologist · NPI 1972964468

San Diego State University is a Speech-Language Pathologist in San Diego, California. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2

Practice location Address checks out

5500 Campanile Dr
San Diego, CA 92182-1518
Phone: (619) 594-7747
Fax: (619) 594-5917
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Audiologist-Hearing Aid Fitter (primary) Taxonomy 237600000X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1972964468
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSan Diego State University
Authorized official Agnes Wong Nickerson — Associate Vp Of Financial Operation · (619) 594-6017
Other names San Diego State University Speech, Language And Hearing Clinic
NPI enumeratedMarch 11, 2016
Last updated in NPPESMarch 11, 2016
Mailing address5500 Campanile Dr, San Diego, CA 92182-1518

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