Provider Demographics
NPI:1639466154
Name:KAYEM, ERIN D (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:D
Last Name:KAYEM
Suffix:
Gender:F
Credentials: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 1:8055 W MANCHESTER AVE
Mailing Address - Street 2:SUITE 705
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7960
Mailing Address - Country:US
Mailing Address - Phone:310-598-1820
Mailing Address - Fax:310-526-3438
Practice Address - Street 1:8055 W MANCHESTER AVE
Practice Address - Street 2:SUITE 705
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7960
Practice Address - Country:US
Practice Address - Phone:310-598-1820
Practice Address - Fax:310-526-3438
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP 10919OtherSPEECH PATHOLOGY LICENSE