Healthcare Provider Details

I. General information

NPI: 1619897311
Provider Name (Legal Business Name): COURTNEY EMILY BUTLER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16111 PLUMMER ST
SEPULVEDA CA
91343-2036
US

IV. Provider business mailing address

16111 PLUMMER ST
SEPULVEDA CA
91343-2036
US

V. Phone/Fax

Practice location:
  • Phone: 818-891-7711
  • Fax:
Mailing address:
  • Phone: 818-891-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number14291163-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: