Provider Demographics
NPI:1982347464
Name:CALONZO, MICHELLE FLORES (SLPA)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:FLORES
Last Name:CALONZO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:GABRIEL
Other - Last Name:FLORES-CALONZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FLORES
Mailing Address - Street 1:PO BOX 4712
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-4712
Mailing Address - Country:US
Mailing Address - Phone:657-243-6288
Mailing Address - Fax:
Practice Address - Street 1:2850 ARTESIA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3412
Practice Address - Country:US
Practice Address - Phone:424-275-9968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87512355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant