Provider Demographics
NPI:1992152870
Name:CUADRO, CRYSTAL DOREGIOS
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:DOREGIOS
Last Name:CUADRO
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 1:3521 LOMITA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5039
Mailing Address - Country:US
Mailing Address - Phone:310-856-8528
Mailing Address - Fax:310-856-8532
Practice Address - Street 1:3521 LOMITA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5039
Practice Address - Country:US
Practice Address - Phone:310-856-8528
Practice Address - Fax:310-856-8532
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 37922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant