Provider Demographics
NPI:1710417076
Name:MILTON, SANDRA (MA, CCC-SLP, CCM)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:MILTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13636 VENTURA BLVD
Mailing Address - Street 2:#420
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3700
Mailing Address - Country:US
Mailing Address - Phone:818-763-9997
Mailing Address - Fax:818-763-9979
Practice Address - Street 1:13636 VENTURA BLVD
Practice Address - Street 2:#420
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3700
Practice Address - Country:US
Practice Address - Phone:818-763-9997
Practice Address - Fax:818-763-9979
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist