Provider Demographics
NPI:1437474210
Name:BAYNEY-FLEENER, VATTENE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VATTENE
Middle Name:
Last Name:BAYNEY-FLEENER
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 1:5806 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-2013
Mailing Address - Country:US
Mailing Address - Phone:213-706-5158
Mailing Address - Fax:
Practice Address - Street 1:5806 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-2013
Practice Address - Country:US
Practice Address - Phone:213-706-5158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15837235Z00000X
IA002011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist