Provider Demographics
NPI:1508453937
Name:OWENS, CHRISTINA (BA SLPA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:BA SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30985 SAMANTHA LN
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2992
Mailing Address - Country:US
Mailing Address - Phone:951-551-6850
Mailing Address - Fax:
Practice Address - Street 1:31205 PAUBA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6220
Practice Address - Country:US
Practice Address - Phone:951-693-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist