Provider Demographics
NPI:1487206785
Name:WHITEFIELD, PAIGE NICOLE (SLPA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICOLE
Last Name:WHITEFIELD
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-7326
Mailing Address - Country:US
Mailing Address - Phone:916-791-8804
Mailing Address - Fax:
Practice Address - Street 1:3498 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:RESCUE
Practice Address - State:CA
Practice Address - Zip Code:95672-9625
Practice Address - Country:US
Practice Address - Phone:530-391-8670
Practice Address - Fax:888-538-0573
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50512355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant