Provider Demographics
NPI:1821310954
Name:STORY, MARIA KRISTINA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:KRISTINA
Last Name:STORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 NORWALK BLVD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1838
Mailing Address - Country:US
Mailing Address - Phone:562-926-5566
Mailing Address - Fax:
Practice Address - Street 1:16700 NORWALK BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1838
Practice Address - Country:US
Practice Address - Phone:562-926-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2014-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist