Provider Demographics
NPI:1043892201
Name:JANAIRO, KATRINA LS (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:LS
Last Name:JANAIRO
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 1:14637 DECOY LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0413
Mailing Address - Country:US
Mailing Address - Phone:909-263-3934
Mailing Address - Fax:
Practice Address - Street 1:6370 MAGNOLIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2406
Practice Address - Country:US
Practice Address - Phone:562-380-3923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15508235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist