Provider Demographics
NPI:1245076116
Name:BARAJAS, NOELLE JULIET (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:JULIET
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 COSMOS ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3593
Mailing Address - Country:US
Mailing Address - Phone:909-456-0715
Mailing Address - Fax:
Practice Address - Street 1:101 SPRING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4930
Practice Address - Country:US
Practice Address - Phone:626-986-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist