Provider Demographics
NPI:1861036659
Name:DRIZIN, CHAYA MUSHKA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHAYA
Middle Name:MUSHKA
Last Name:DRIZIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3015
Mailing Address - Country:US
Mailing Address - Phone:323-238-6000
Mailing Address - Fax:
Practice Address - Street 1:120 N ORANGE DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3015
Practice Address - Country:US
Practice Address - Phone:323-238-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29415235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist