Healthcare Provider Details

I. General information

NPI: 1235598236
Provider Name (Legal Business Name): BRENDA M CORTEZ MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRENDA M CARRILLO MS CCC-SLP

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 ALTON PKWY # 1
IRVINE CA
92618-3734
US

IV. Provider business mailing address

6640 ALTON PKWY # 1
IRVINE CA
92618-3734
US

V. Phone/Fax

Practice location:
  • Phone: 949-932-5000
  • Fax:
Mailing address:
  • Phone: 949-932-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: