Provider Demographics
NPI:1972067163
Name:PELAYO, HELENA JANETTE
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:JANETTE
Last Name:PELAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30951 HANOVER LN APT 1409
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-6632
Mailing Address - Country:US
Mailing Address - Phone:951-295-6485
Mailing Address - Fax:
Practice Address - Street 1:36243 INLAND VALLEY DR STE 40
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-9547
Practice Address - Country:US
Practice Address - Phone:909-992-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist