Provider Demographics
NPI:1639466154
Name:KAYEM, ERIN D (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:D
Last Name:KAYEM
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 1:12063 JEFFERSON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6219
Mailing Address - Country:US
Mailing Address - Phone:310-821-3640
Mailing Address - Fax:310-526-3438
Practice Address - Street 1:12063 JEFFERSON BLVD STE A
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6219
Practice Address - Country:US
Practice Address - Phone:310-821-3640
Practice Address - Fax:310-526-3438
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP 10919OtherSPEECH PATHOLOGY LICENSE