Provider Demographics
NPI:1871304691
Name:KATZ, EILEEN JESSICA SHELDEN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:JESSICA SHELDEN
Last Name:KATZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:JESSICA
Other - Last Name:SHELDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:6333 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4406
Mailing Address - Country:US
Mailing Address - Phone:310-595-5743
Mailing Address - Fax:
Practice Address - Street 1:6333 COLGATE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4406
Practice Address - Country:US
Practice Address - Phone:310-595-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist