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General NPI Number Information
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NPI Number | 1831600840
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Entity Type | Individual
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Provider Name | RAQUEL YEZMIN DE CASAS
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Gender | Female
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 1045 W REDONDO BEACH BLVD STE 135
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City | GARDENA
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State | CA
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Zip | 90247-4104
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Country | US
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Telephone | 562-299-3292
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | PARAMOUNT
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State | CA
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Zip | 90723-0111
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Country | US
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Telephone | 562-299-3292
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 4555
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License Number State | CA
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