Healthcare Provider Details

I. General information

NPI: 1083541692
Provider Name (Legal Business Name): ANIKA NOELLE COLBURN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29992 HUNTER RD STE 206
MURRIETA CA
92563-4765
US

IV. Provider business mailing address

29992 HUNTER RD STE 106
MURRIETA CA
92563-2769
US

V. Phone/Fax

Practice location:
  • Phone: 951-299-2220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: