Provider Demographics
NPI:1063843514
Name:BIONDO, TINA M. (SLPA)
Entity Type:Individual
Prefix:
First Name:TINA M.
Middle Name:
Last Name:BIONDO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36883 LITTLEROCK RANCHOS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-1946
Mailing Address - Country:US
Mailing Address - Phone:661-974-0722
Mailing Address - Fax:
Practice Address - Street 1:23504 LYONS AVE
Practice Address - Street 2:103 B
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2500
Practice Address - Country:US
Practice Address - Phone:661-253-0245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10322355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant