Provider Demographics
NPI:1851484588
Name:TROQUATO, AILEEN (MA,)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:
Last Name:TROQUATO
Suffix:
Gender:F
Credentials:MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5081 BARNETT LOOP ROAD
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682
Mailing Address - Country:US
Mailing Address - Phone:530-677-8620
Mailing Address - Fax:
Practice Address - Street 1:3106 GABBERT DRIVE
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682
Practice Address - Country:US
Practice Address - Phone:530-677-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist