Provider Demographics
NPI:1295971869
Name:RODEN, ANGELA J (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:J
Last Name:RODEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 S SERRANO AVE # 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1158
Mailing Address - Country:US
Mailing Address - Phone:213-618-0208
Mailing Address - Fax:213-382-5393
Practice Address - Street 1:906 S SERRANO AVE # 402
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-1158
Practice Address - Country:US
Practice Address - Phone:213-618-0208
Practice Address - Fax:213-382-5393
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist