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General NPI Number Information
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NPI Number | 1902174659
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Entity Type | Individual
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Provider Name | ALICIA JONEKA EARL M.A.T., M.S.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 4401 CRENSHAW BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90043-1227
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Country | US
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Telephone | 323-291-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 CRENSHAW BLVD STE 215
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City | LOS ANGELES
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State | CA
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Zip | 90043-1200
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Country | US
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Telephone | 323-291-7100
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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 | 116913
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP008849
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP29490
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License Number State | CA
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