Provider Demographics
NPI:1164759932
Name:RAY, NATASHA (MA-SLP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 PORTOLA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7725
Mailing Address - Country:US
Mailing Address - Phone:805-650-6290
Mailing Address - Fax:
Practice Address - Street 1:2387 PORTOLA RD
Practice Address - Street 2:SUITE A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7725
Practice Address - Country:US
Practice Address - Phone:805-650-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 6014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist