Provider Demographics
NPI:1376089680
Name:LIMSON, CASSANDRA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:LIMSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BIRCH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2226
Mailing Address - Country:US
Mailing Address - Phone:949-955-0010
Mailing Address - Fax:
Practice Address - Street 1:3900 BIRCH ST STE 103
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2226
Practice Address - Country:US
Practice Address - Phone:949-955-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2023-01-02
Deactivation Date:2021-07-21
Deactivation Code:
Reactivation Date:2022-12-08
Provider Licenses
StateLicense IDTaxonomies
CA26529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist