Provider Demographics
NPI:1245084854
Name:CARRANZA, SUMMER MARIAH (BA CSD, CERT SLPA)
Entity type:Individual
Prefix:MISS
First Name:SUMMER
Middle Name:MARIAH
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:BA CSD, CERT SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1027
Mailing Address - Country:US
Mailing Address - Phone:562-400-2015
Mailing Address - Fax:
Practice Address - Street 1:18837 BROOKHURST ST STE 109
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7301
Practice Address - Country:US
Practice Address - Phone:714-861-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81012355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant