Provider Demographics
NPI:1265841456
Name:RONQUILLO, MELANIE MARIA (BACHLOR OF ARTS)
Entity type:Individual
Prefix:MISS
First Name:MELANIE
Middle Name:MARIA
Last Name:RONQUILLO
Suffix:
Gender:F
Credentials:BACHLOR OF ARTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CALLE ROSAMARIA
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-4438
Mailing Address - Country:US
Mailing Address - Phone:626-485-0227
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3158
Practice Address - Country:US
Practice Address - Phone:562-698-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 28102355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant