Provider Demographics
NPI:1871841940
Name:ASHKENAZY, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ASHKENAZY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 N ORANGE DR APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7929
Mailing Address - Country:US
Mailing Address - Phone:323-333-1205
Mailing Address - Fax:
Practice Address - Street 1:12411 SLAUSON AVE STE H
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2835
Practice Address - Country:US
Practice Address - Phone:562-693-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist