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General NPI Number Information
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NPI Number | 1326952342
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Entity Type | Individual
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Provider Name | GABRIELA HEREDIA CCC-SLP, CLC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 650 LA SEDA RD SPC 12D
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City | LA PUENTE
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State | CA
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Zip | 91744-6072
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Country | US
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Telephone | 281-630-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 650 LA SEDA RD SPC 12D
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City | LA PUENTE
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State | CA
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Zip | 91744-6072
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Country | US
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Telephone | 281-630-6828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP40677
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License Number State | CA
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