Provider Demographics
NPI:1346362092
Name:PENDARVIS, MARIA CRISTINA (MS)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CRISTINA
Last Name:PENDARVIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:CRISTINA
Other - Last Name:GASTEL-PENDARVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:21630 MINNEHAHA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2141
Mailing Address - Country:US
Mailing Address - Phone:818-998-1171
Mailing Address - Fax:
Practice Address - Street 1:5601 DE SOTO AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-3369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP3142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist