Provider Demographics
NPI:1225816705
Name:YSIP, ALDRIN ALLEN (MA,CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ALDRIN
Middle Name:ALLEN
Last Name:YSIP
Suffix:
Gender:M
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 VIA NAVARRA
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-2308
Mailing Address - Country:US
Mailing Address - Phone:805-406-1268
Mailing Address - Fax:
Practice Address - Street 1:24328 VERMONT AVE STE 318
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2314
Practice Address - Country:US
Practice Address - Phone:424-250-9615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14317203261QH0700X
CA35612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech