Provider Demographics
NPI:1841879996
Name:AGUILAR-GALCERAN, MELISSA ANN (SLP/CCC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:AGUILAR-GALCERAN
Suffix:
Gender:F
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 1:52471 AVENIDA MARTINEZ
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-3360
Mailing Address - Country:US
Mailing Address - Phone:760-600-6202
Mailing Address - Fax:
Practice Address - Street 1:87225 CHURCH ST
Practice Address - Street 2:
Practice Address - City:THERMAL
Practice Address - State:CA
Practice Address - Zip Code:92274-8901
Practice Address - Country:US
Practice Address - Phone:760-848-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24528235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty