Provider Demographics
NPI:1497345433
Name:SHAND-BETTS, ANNACHRISTI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANNACHRISTI
Middle Name:
Last Name:SHAND-BETTS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:
Other - Last Name:SHAND-BETTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:325 N ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1603
Mailing Address - Country:US
Mailing Address - Phone:310-382-0925
Mailing Address - Fax:
Practice Address - Street 1:325 N ADAMS AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1603
Practice Address - Country:US
Practice Address - Phone:310-382-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty