Healthcare Provider Details

I. General information

NPI: 1619316205
Provider Name (Legal Business Name): CHERYL SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 AUTO CENTER DR. #D
PALMDALE CA
93551
US

IV. Provider business mailing address

861 AUTO CENTER DR. #D
PALMDALE CA
93551
US

V. Phone/Fax

Practice location:
  • Phone: 661-945-7878
  • Fax:
Mailing address:
  • Phone: 661-945-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: