Healthcare Provider Details

I. General information

NPI: 1861549289
Provider Name (Legal Business Name): COMMUNITY SPEECH AND HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18740 VENTURA BLVD SUITE 100
TARZANA CA
91356-3366
US

IV. Provider business mailing address

18740 VENTURA BLVD SUITE 100
TARZANA CA
91356-3366
US

V. Phone/Fax

Practice location:
  • Phone: 818-774-0224
  • Fax: 818-774-1935
Mailing address:
  • Phone: 818-774-0224
  • Fax: 818-774-1935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL A EDWARDS
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 818-774-0224