Provider Demographics
NPI:1083268817
Name:HAROLD, CHRISTINA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:HAROLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BEATTY PL
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4504
Mailing Address - Country:US
Mailing Address - Phone:310-529-7897
Mailing Address - Fax:
Practice Address - Street 1:5567 RESEDA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2648
Practice Address - Country:US
Practice Address - Phone:818-968-2337
Practice Address - Fax:818-697-5778
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53772355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant