Provider Demographics
NPI:1780177709
Name:AQUINO, MARIA KRISTINA SAAVEDRA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA KRISTINA
Middle Name:SAAVEDRA
Last Name:AQUINO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:SAAVEDRA
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2390 E ORANGEWOOD AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-6139
Mailing Address - Country:US
Mailing Address - Phone:714-922-4453
Mailing Address - Fax:
Practice Address - Street 1:2390 E ORANGEWOOD AVE STE 400
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-6139
Practice Address - Country:US
Practice Address - Phone:714-922-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26226OtherSPEECH LANGUAGE PATHOLOGY