Provider Demographics
NPI:1194971200
Name:OWEN, CHRISTI T (MS CCC-SLP CA#7558)
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:T
Last Name:OWEN
Suffix:
Gender:F
Credentials:MS CCC-SLP CA#7558
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 PORT TIFFIN PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7122
Mailing Address - Country:US
Mailing Address - Phone:714-606-4747
Mailing Address - Fax:949-644-6585
Practice Address - Street 1:1851 PORT TIFFIN PL
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7122
Practice Address - Country:US
Practice Address - Phone:714-606-4747
Practice Address - Fax:949-644-6585
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA7558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist