Provider Demographics
NPI:1942442835
Name:CATALYST SLP
Entity Type:Organization
Organization Name:CATALYST SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:JI
Authorized Official - Middle Name:SOO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:213-346-9945
Mailing Address - Street 1:205 S BROADWAY STE 217
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3607
Mailing Address - Country:US
Mailing Address - Phone:213-346-9945
Mailing Address - Fax:866-820-1703
Practice Address - Street 1:205 S BROADWAY STE 217
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3607
Practice Address - Country:US
Practice Address - Phone:213-346-9945
Practice Address - Fax:866-820-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10983235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty