Provider Demographics
NPI:1992104723
Name:ZUNIGA, VANESSA YVETTE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:YVETTE
Last Name:ZUNIGA
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 1:5106 KESTER AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1362
Mailing Address - Country:US
Mailing Address - Phone:915-276-1811
Mailing Address - Fax:
Practice Address - Street 1:19100 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3239
Practice Address - Country:US
Practice Address - Phone:915-276-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist