Provider Demographics
NPI:1538500012
Name:WASCHER, VICTORIA ALEXIS (MA)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:ALEXIS
Last Name:WASCHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 S CENTINELA AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-7112
Mailing Address - Country:US
Mailing Address - Phone:805-312-2983
Mailing Address - Fax:
Practice Address - Street 1:4470 S CENTINELA AVE
Practice Address - Street 2:APT. 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6200
Practice Address - Country:US
Practice Address - Phone:805-312-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8255235Z00000X
CASP21842235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist