Individual
JAMIE CARISSA D PLATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 N SANTA ANITA AVE STE 105, ARCADIA, CA 91006-3157
(626) 623-6355
Mailing address
329 E CALIFORNIA BLVD APT 2, PASADENA, CA 91106-3656
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
4799
CA
235Z00000X
Speech-Language Pathologist
14044
CA
235Z00000X
Speech-Language Pathologist
Primary
30771
CA
Other
Enumeration date
09/12/2017
Last updated
10/27/2020
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