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Individual

DEREENA KUTTOOKARAN PAULOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1305 E VINE ST, LODI, CA 95240-3148
(909) 396-8900
(909) 396-8900
Mailing address
1701 S MILLS AVE APT 66, LODI, CA 95242-4260
(909) 396-8900
(909) 396-8900

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
32105
CA

Other

Enumeration date
07/30/2026
Last updated
07/30/2026
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