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General NPI Number Information
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NPI Number | 1447193339
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Entity Type | Organization
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Legal Business Name | LISA FITE SPEECH LANGUAGE PATHOLOGY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 15218 SUMMIT AVE STE 300-218
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-600-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 15218 SUMMIT AVE STE 300-218
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-600-5323
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Fax |
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Authorized Official
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Title or Position | CEO/CFO/SECRETARY
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Name | LISA JEAN FITE
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Credential | M.A. CCC-SLP
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Telephone | 909-600-5323
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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 |
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License Number State |
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