Provider Demographics
NPI:1194074054
Name:BROOKER, PAMELA CAPIN (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CAPIN
Last Name:BROOKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7307 GREBE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4868
Mailing Address - Country:US
Mailing Address - Phone:760-579-8196
Mailing Address - Fax:
Practice Address - Street 1:7307 GREBE DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4868
Practice Address - Country:US
Practice Address - Phone:760-579-8196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 19719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist