Provider Demographics
NPI:1447694898
Name:VILLARREAL, CATHLEEN L (SLP)
Entity type:Individual
Prefix:MISS
First Name:CATHLEEN
Middle Name:L
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 CEDROS AVE
Mailing Address - Street 2:UNIT 115
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2801
Mailing Address - Country:US
Mailing Address - Phone:323-761-9712
Mailing Address - Fax:
Practice Address - Street 1:4501 CEDROS AVE
Practice Address - Street 2:UNIT 115
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2801
Practice Address - Country:US
Practice Address - Phone:323-761-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-28
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist