Provider Demographics
NPI:1760359210
Name:NEUBAUER, HEATHER (SLPA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53845 AVENIDA HERRERA
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-3561
Mailing Address - Country:US
Mailing Address - Phone:760-564-4726
Mailing Address - Fax:
Practice Address - Street 1:79440 CORPORATE CENTER DR STE 113
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-7244
Practice Address - Country:US
Practice Address - Phone:760-564-4726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8222355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant