Provider Demographics
NPI:1679233969
Name:CHEVALIER, SHAUN COLETTE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:COLETTE
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:COLETTE
Other - Last Name:CHEVALIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:253 S BROADWAY APT 505
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3619
Mailing Address - Country:US
Mailing Address - Phone:626-864-3334
Mailing Address - Fax:
Practice Address - Street 1:253 S BROADWAY APT 505
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3619
Practice Address - Country:US
Practice Address - Phone:626-864-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15328235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist