Provider Demographics
NPI:1053523001
Name:ALBA, PATRICA L R (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICA
Middle Name:L R
Last Name:ALBA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 CANAL DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1204
Mailing Address - Country:US
Mailing Address - Phone:530-244-7227
Mailing Address - Fax:530-244-7275
Practice Address - Street 1:2005 CANAL DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1204
Practice Address - Country:US
Practice Address - Phone:530-244-7227
Practice Address - Fax:530-244-7275
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP7956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP0079560Medicaid