Provider Demographics
NPI:1457735847
Name:HUERTA, LETICIA ESMERALDA (SLPA)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:ESMERALDA
Last Name:HUERTA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 W G ST
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2008
Mailing Address - Country:US
Mailing Address - Phone:909-709-1004
Mailing Address - Fax:
Practice Address - Street 1:967 W G ST
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2008
Practice Address - Country:US
Practice Address - Phone:909-709-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant