Provider Demographics
NPI:1013520642
Name:LOZA -HINE, TATIANA (SLP)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:LOZA -HINE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:TATIANA
Other - Middle Name:
Other - Last Name:LOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:1064 MANZA CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5872
Mailing Address - Country:US
Mailing Address - Phone:916-335-0766
Mailing Address - Fax:
Practice Address - Street 1:600 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4110
Practice Address - Country:US
Practice Address - Phone:916-782-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37147235Z00000X
CA60932355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant