Provider Demographics
NPI:1538670674
Name:ENGELHARDT, LOIS TRUDEAU (SLPD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:TRUDEAU
Last Name:ENGELHARDT
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 DEWAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4909 MURPHY CANYON RD STE 310
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4301
Practice Address - Country:US
Practice Address - Phone:800-787-6787
Practice Address - Fax:858-429-7992
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist