Healthcare Provider Details

I. General information

NPI: 1770204430
Provider Name (Legal Business Name): KEVIN FURLANETTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 ANGELUS AVE
ROSEMEAD CA
91770-3619
US

IV. Provider business mailing address

2150 ANGELUS AVE
ROSEMEAD CA
91770-3619
US

V. Phone/Fax

Practice location:
  • Phone: 626-307-3348
  • Fax:
Mailing address:
  • Phone: 626-307-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number35698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: