Provider Demographics
NPI:1821422718
Name:FLORES, MARIA JOSE (MA SLP CCC)
Entity Type:Individual
Prefix:
First Name:MARIA JOSE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MA SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 GLEN DR
Mailing Address - Street 2:UNIT 1
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4575
Mailing Address - Country:US
Mailing Address - Phone:626-224-0177
Mailing Address - Fax:
Practice Address - Street 1:148 GLEN DR
Practice Address - Street 2:UNIT 1
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4575
Practice Address - Country:US
Practice Address - Phone:626-224-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist