Provider Demographics
NPI:1912050022
Name:MANDEL, KAREN L (M S)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:MANDEL
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9312 SHOSHONE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-2327
Mailing Address - Country:US
Mailing Address - Phone:818-421-1422
Mailing Address - Fax:818-701-5906
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:905
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2601
Practice Address - Country:US
Practice Address - Phone:818-990-5715
Practice Address - Fax:818-990-4540
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#8192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist