Provider Demographics
NPI:1508003211
Name:BARNETT, KIA HUGHES (EDD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIA
Middle Name:HUGHES
Last Name:BARNETT
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:MISS
Other - First Name:KIA
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1322 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4416
Mailing Address - Country:US
Mailing Address - Phone:434-489-5249
Mailing Address - Fax:
Practice Address - Street 1:3521 LOMITA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5040
Practice Address - Country:US
Practice Address - Phone:434-489-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16004235Z00000X
CASP16004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist