Healthcare Provider Details

I. General information

NPI: 1821410952
Provider Name (Legal Business Name): PRANATHI REDDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W 6TH ST STE 111
LOS ANGELES CA
90017-1823
US

IV. Provider business mailing address

6120 WINANS DR APT 1
LOS ANGELES CA
90068-2263
US

V. Phone/Fax

Practice location:
  • Phone: 323-404-1024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: