Provider Demographics
NPI:1760473847
Name:SINGLETON, SANDRA LYNNE (EDD SLP CCC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNNE
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:EDD SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4648 DEER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RESCUE
Mailing Address - State:CA
Mailing Address - Zip Code:95672-9657
Mailing Address - Country:US
Mailing Address - Phone:530-387-1274
Mailing Address - Fax:
Practice Address - Street 1:4648 DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:RESCUE
Practice Address - State:CA
Practice Address - Zip Code:95672-9657
Practice Address - Country:US
Practice Address - Phone:530-387-1274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2015-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004360235Z00000X
CA4982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP4982OtherDEPT. OF CONSUMER AFFAIRS - SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY BOARD