Provider Demographics
NPI:1851615967
Name:NEWCOMER, KRISTEN MICHAL (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MICHAL
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 GRAND AVE
Mailing Address - Street 2:#208
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2370
Mailing Address - Country:US
Mailing Address - Phone:760-730-9675
Mailing Address - Fax:760-730-9669
Practice Address - Street 1:785 GRAND AVE
Practice Address - Street 2:#208
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2370
Practice Address - Country:US
Practice Address - Phone:760-730-9675
Practice Address - Fax:760-730-9669
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10873235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist