Basic Information
| Provider Information | |||||||||
| NPI: | 1538670674 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGELHARDT | ||||||||
| FirstName: | LOIS | ||||||||
| MiddleName: | TRUDEAU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | SLPD, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1817 DEWAYNE AVE | ||||||||
| Address2: | |||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930103819 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4909 MURPHY CANYON RD STE 310 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921234301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007876787 | ||||||||
| FaxNumber: | 8584297992 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2017 | ||||||||
| LastUpdateDate: | 04/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.