Provider Demographics
NPI:1578823498
Name:ALDINOVA-REDANSKA, ALBENA M (MA,MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALBENA
Middle Name:M
Last Name:ALDINOVA-REDANSKA
Suffix:
Gender:F
Credentials:MA,MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E SUNNYOAKS AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-6639
Mailing Address - Country:US
Mailing Address - Phone:408-370-3907
Mailing Address - Fax:
Practice Address - Street 1:125 E SUNNYOAKS AVE STE 111
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6639
Practice Address - Country:US
Practice Address - Phone:408-370-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist