Basic Information
| Provider Information | |||||||||
| NPI: | 1548507213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRISPELL | ||||||||
| FirstName: | KARENINA | ||||||||
| MiddleName: | ANN | ||||||||
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| OtherLastName: | PINEDA | ||||||||
| OtherFirstName: | KARNINA | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 936 S DAVID ST | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928021816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888087838 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 249 E OCEAN BLVD STE 400 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908024806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888087838 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2013 | ||||||||
| LastUpdateDate: | 03/25/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | 1145 | CA | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.