Healthcare Provider Details

I. General information

NPI: 1871033449
Provider Name (Legal Business Name): BARBARA MARTIN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N JACKSON ST
GLENDALE CA
91206-4380
US

IV. Provider business mailing address

2056 PALOMA ST
PASADENA CA
91104-4821
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-3111
  • Fax:
Mailing address:
  • Phone: 626-532-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number39347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: