Provider Demographics
NPI:1265836118
Name:CHATTERBOXES SPEECH & LANGUAGE PATHOLOGY
Entity Type:Organization
Organization Name:CHATTERBOXES SPEECH & LANGUAGE PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEEYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-933-1413
Mailing Address - Street 1:2990 S SEPULVEDA BLVD
Mailing Address - Street 2:#308
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-0002
Mailing Address - Country:US
Mailing Address - Phone:310-444-0111
Mailing Address - Fax:
Practice Address - Street 1:2990 S SEPULVEDA BLVD
Practice Address - Street 2:#308
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-0002
Practice Address - Country:US
Practice Address - Phone:310-444-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21076235Z00000X
PA21917235Z00000X
CA21662235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty