Provider Demographics
NPI:1801338108
Name:LESTER, CORRINE ADAME
Entity type:Individual
Prefix:
First Name:CORRINE
Middle Name:ADAME
Last Name:LESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CORRINE
Other - Middle Name:ADAME
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SPEECH AND LANGUAGE
Mailing Address - Street 1:1268 TUSCANY DR
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-3171
Mailing Address - Country:US
Mailing Address - Phone:559-397-2522
Mailing Address - Fax:
Practice Address - Street 1:7111 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2965
Practice Address - Country:US
Practice Address - Phone:559-224-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12134650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist