Provider Demographics
NPI:1821272543
Name:SANDIFORD, GIVONA ANDELYN (PHD, CCC/SLP)
Entity Type:Individual
Prefix:DR
First Name:GIVONA
Middle Name:ANDELYN
Last Name:SANDIFORD
Suffix:
Gender:F
Credentials:PHD, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32120 TEMECULA PKWY # 1023
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6801
Mailing Address - Country:US
Mailing Address - Phone:707-345-1887
Mailing Address - Fax:707-666-6067
Practice Address - Street 1:31035 BUNKER DR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-3904
Practice Address - Country:US
Practice Address - Phone:707-345-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist