Provider Demographics
NPI:1770855926
Name:ANKENY, DEBORAH L (MA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:ANKENY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26638 SIERRA VIS
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3334
Mailing Address - Country:US
Mailing Address - Phone:949-348-1980
Mailing Address - Fax:
Practice Address - Street 1:26638 SIERRA VIS
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3334
Practice Address - Country:US
Practice Address - Phone:949-348-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist