Individual
ALYSSA CHRISTIE PANJAITAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S HAVEN AVE, ONTARIO, CA 91761-2969
(909) 390-1313
Mailing address
13703 CABRILLO CT, FONTANA, CA 92336-3406
(909) 648-4234
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
26296
CA
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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