Healthcare Provider Details

I. General information

NPI: 1538096375
Provider Name (Legal Business Name): PAMELA LEE GREENHALGH SLP, CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13461 RAMONA AVE
CHINO CA
91710-5029
US

IV. Provider business mailing address

835 EL DORADO DR
FULLERTON CA
92832-1217
US

V. Phone/Fax

Practice location:
  • Phone: 909-628-1202
  • Fax: 909-548-6095
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP6708
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: