MEDICARE: MRS. KRISTEN MARIE DELGADO M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	18250	CA

General Provider Information

NPI Number	:	1235579087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTEN MARIE DELGADO M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	7587 GRANADA DR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-1210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7587 GRANADA DR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-1210
Country	:	US
Telephone Number	:	714-232-2213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	12/03/2013

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