Provider Demographics
NPI:1306551213
Name:KARIKE, AVINASH (SLP-CCC)
Entity type:Individual
Prefix:
First Name:AVINASH
Middle Name:
Last Name:KARIKE
Suffix:
Gender:M
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 ETIWANDA AVE APT 7107
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8708
Mailing Address - Country:US
Mailing Address - Phone:951-500-0918
Mailing Address - Fax:
Practice Address - Street 1:706 N DIAMOND BAR BLVD STE B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1059
Practice Address - Country:US
Practice Address - Phone:909-396-8900
Practice Address - Fax:909-396-9900
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist