Healthcare Provider Details

I. General information

NPI: 1356535785
Provider Name (Legal Business Name): SUMMER FOUSIEH PUSKAS C.C.C. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUMMER ISRAWI C.C.C. SLP

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11627 BROOKSHIRE AVE
DOWNEY CA
90241-4911
US

IV. Provider business mailing address

7831 BAIRNSDALE ST
DOWNEY CA
90240-2618
US

V. Phone/Fax

Practice location:
  • Phone: 562-307-0885
  • Fax:
Mailing address:
  • Phone: 562-307-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: