Individual
ALEXIS BASULTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12411 SLAUSON AVE STE H, WHITTIER, CA 90606-2835
(562) 693-5449
Mailing address
12411 SLAUSON AVE STE H, WHITTIER, CA 90606-2835
(562) 693-5449
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
3033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018541949
KAISER
CA
Enumeration date
01/20/2015
Last updated
05/12/2015
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