Provider Demographics
NPI:1194950394
Name:PATEL, SHREYA (MS)
Entity type:Individual
Prefix:MRS
First Name:SHREYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 3RD ST STE 106
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2679
Mailing Address - Country:US
Mailing Address - Phone:626-410-2662
Mailing Address - Fax:
Practice Address - Street 1:1761 3RD ST STE 106
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2679
Practice Address - Country:US
Practice Address - Phone:626-410-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist