Provider Demographics
NPI:1508287806
Name:PFISTER, LIANNE NAHINA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LIANNE
Middle Name:NAHINA
Last Name:PFISTER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:LIANNE
Other - Middle Name:NAHINA
Other - Last Name:PFISTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ABD, MA, CCC-SLP
Mailing Address - Street 1:33871 CALLE CONEJO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-5049
Mailing Address - Country:US
Mailing Address - Phone:949-257-5627
Mailing Address - Fax:949-248-2302
Practice Address - Street 1:420 CAMINO DE ESTRELLA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3509
Practice Address - Country:US
Practice Address - Phone:949-257-5627
Practice Address - Fax:949-248-2302
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist