Provider Demographics
NPI:1003009689
Name:SAUCEDO, ROSALYNDA (BA, SLPA)
Entity Type:Individual
Prefix:MS
First Name:ROSALYNDA
Middle Name:
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:BA, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21520 PIONEER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2604
Mailing Address - Country:US
Mailing Address - Phone:562-865-3644
Mailing Address - Fax:562-865-5244
Practice Address - Street 1:21520 PIONEER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2604
Practice Address - Country:US
Practice Address - Phone:562-865-3644
Practice Address - Fax:562-865-5244
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA15972355S0801X
CAIMFT 81458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant