Provider Demographics
NPI:1013147982
Name:BALKHI, ERICA JANET (M A CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JANET
Last Name:BALKHI
Suffix:
Gender:F
Credentials:M A CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22122 SHADYVALE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-3327
Mailing Address - Country:US
Mailing Address - Phone:949-394-9720
Mailing Address - Fax:949-340-3571
Practice Address - Street 1:25422 TRABUCO RD # 105-323
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2791
Practice Address - Country:US
Practice Address - Phone:949-394-9720
Practice Address - Fax:949-340-3571
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist