Provider Demographics
NPI:1376166785
Name:GALISA, SONNABELL VILLONES (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SONNABELL
Middle Name:VILLONES
Last Name:GALISA
Suffix:
Gender:F
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 1:1300 SARATOGA AVE UNIT 1100
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6411
Mailing Address - Country:US
Mailing Address - Phone:209-813-5425
Mailing Address - Fax:
Practice Address - Street 1:1809 MARSALA WAY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-5201
Practice Address - Country:US
Practice Address - Phone:831-356-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty