Provider Demographics
NPI:1447668710
Name:CHRISTINE LEE STANTON, M.S., CCC/SLP
Entity type:Organization
Organization Name:CHRISTINE LEE STANTON, M.S., CCC/SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:949-922-7703
Mailing Address - Street 1:3300 IRVINE AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3109
Mailing Address - Country:US
Mailing Address - Phone:949-922-7703
Mailing Address - Fax:
Practice Address - Street 1:445 ENCLAVE CIR
Practice Address - Street 2:SUITE 305
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-8214
Practice Address - Country:US
Practice Address - Phone:949-922-7703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP9045252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency