Provider Demographics
NPI:1316515745
Name:CANIZAL, JULIA ISABEL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ISABEL
Last Name:CANIZAL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 ROSEMEAD BLVD APT 123
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-1749
Mailing Address - Country:US
Mailing Address - Phone:562-303-6552
Mailing Address - Fax:
Practice Address - Street 1:4200 ROSEMEAD BLVD
Practice Address - Street 2:APARTMENT 123
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-1749
Practice Address - Country:US
Practice Address - Phone:562-303-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist