Provider Demographics
NPI:1518197268
Name:ALDRICH, ELEANOR ROSS (SLP)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ROSS
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5708
Mailing Address - Country:US
Mailing Address - Phone:530-887-8913
Mailing Address - Fax:
Practice Address - Street 1:262 FOREST CT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5708
Practice Address - Country:US
Practice Address - Phone:530-887-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist