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General NPI Number Information
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NPI Number | 1679241145
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Entity Type | Individual
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Provider Name | CASSANDRA VILLARREAL
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 15928 VENTURA BLVD STE 218
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City | ENCINO
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State | CA
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Zip | 91436-4413
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Country | US
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Telephone | 818-518-9709
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Fax |
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Provider Business Mailing Address
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Address Line | 12222 MOORPARK ST APT 106
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City | STUDIO CITY
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State | CA
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Zip | 91604-5208
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Country | US
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Telephone | 830-421-6145
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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 |
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License Number State |
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