Doctor Name: | MR. CHIKKANAYAKANAHALLI SWAMYSRIDHSIDDHARTHA |
NPI Number: | 1861714867 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | 17429 |
License Number: | 17429 |
Business Practice Address: | 2764 Ridgeline Dr Apt # 108 Corona, CA - 928828759 |
Business Phone Number: | 9514963587 |
Business Fax Number: | 9514963587 |
Mailing Address: | 2764 Ridgeline Dr, Apt# 108 CORONA |
State: | CA |
Postal Code: | 928828759 |
Phone Number: | 9514963587 |
Fax Number: | 9514963587 |
NPI Enumeration Date: | 02/18/2010 |
NPI Last Update Date: | 01/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 17429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |