Provider Demographics
NPI:1770923070
Name:SHEFER, SYNDI LISA (MS)
Entity type:Individual
Prefix:MRS
First Name:SYNDI
Middle Name:LISA
Last Name:SHEFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SYNDI
Other - Middle Name:
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 W. PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-923-1527
Mailing Address - Fax:714-639-2282
Practice Address - Street 1:17861 VON KARMAN AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614
Practice Address - Country:US
Practice Address - Phone:855-901-7742
Practice Address - Fax:949-387-4852
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist