Healthcare Provider Details

I. General information

NPI: 1366372716
Provider Name (Legal Business Name): ERIN TETLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN BROWN MS SLP -CCC

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10058 ARROWHEAD RD
PHELAN CA
92371-5506
US

IV. Provider business mailing address

PO BOX 3208
WRIGHTWOOD CA
92397-3208
US

V. Phone/Fax

Practice location:
  • Phone: 760-949-4888
  • Fax:
Mailing address:
  • Phone: 760-662-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: