Healthcare Provider Details

I. General information

NPI: 1689589517
Provider Name (Legal Business Name): KRISTY ANN DALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S HARBOR BLVD
ANAHEIM CA
92805-5531
US

IV. Provider business mailing address

1001 S EAST ST
ANAHEIM CA
92805-5749
US

V. Phone/Fax

Practice location:
  • Phone: 714-517-8968
  • Fax: 714-956-2894
Mailing address:
  • Phone: 714-517-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: