Provider Demographics
NPI:1851680193
Name:ALIYEVA, CARMEN E (AUD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:E
Last Name:ALIYEVA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4158 KEEVER AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3015
Mailing Address - Country:US
Mailing Address - Phone:714-566-5546
Mailing Address - Fax:
Practice Address - Street 1:4158 KEEVER AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3015
Practice Address - Country:US
Practice Address - Phone:714-566-5546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2758231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist