Provider Demographics
NPI:1912396383
Name:SIVAKUMARAN, SARUMATHI (MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:SARUMATHI
Middle Name:
Last Name:SIVAKUMARAN
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3873 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-4128
Mailing Address - Country:US
Mailing Address - Phone:626-497-5537
Mailing Address - Fax:
Practice Address - Street 1:3873 STEWART AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-4128
Practice Address - Country:US
Practice Address - Phone:626-497-5537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist