Provider Demographics
NPI:1659177442
Name:CHICHIL, IVONNE SOFIA
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:SOFIA
Last Name:CHICHIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9832 BEACHY AVE
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-5205
Mailing Address - Country:US
Mailing Address - Phone:818-264-9670
Mailing Address - Fax:
Practice Address - Street 1:17337 VENTURA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4039
Practice Address - Country:US
Practice Address - Phone:714-363-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9385235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist