Provider Demographics
NPI:1578030086
Name:PEARLSTONE, DANIEL A (SLP CCC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:PEARLSTONE
Suffix:
Gender:M
Credentials:SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26651 CORTINA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5428
Mailing Address - Country:US
Mailing Address - Phone:154-608-9338
Mailing Address - Fax:
Practice Address - Street 1:26651 CORTINA DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5428
Practice Address - Country:US
Practice Address - Phone:154-608-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASHA14095144235Z00000X
CASP27939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist