Provider Demographics
NPI:1215659529
Name:HIGAREDA FLORES, ESTEFANIA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ESTEFANIA
Middle Name:
Last Name:HIGAREDA FLORES
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 1:1700 E YALE ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-2254
Mailing Address - Country:US
Mailing Address - Phone:909-319-4192
Mailing Address - Fax:
Practice Address - Street 1:22365 BARTON RD STE 104
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5037
Practice Address - Country:US
Practice Address - Phone:909-824-2899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist