Provider Demographics
NPI:1619671880
Name:ANDRIAS, SERLY (MS)
Entity Type:Individual
Prefix:
First Name:SERLY
Middle Name:
Last Name:ANDRIAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8341 GRENOBLE ST UNIT 22
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2806
Mailing Address - Country:US
Mailing Address - Phone:818-939-4627
Mailing Address - Fax:
Practice Address - Street 1:16255 VENTURA BLVD STE 1015
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2318
Practice Address - Country:US
Practice Address - Phone:818-941-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty