Provider Demographics
NPI:1003795550
Name:RYBAKOVA, MARIYA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:RYBAKOVA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 TOPANGA CANYON BLVD APT B106
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4615
Mailing Address - Country:US
Mailing Address - Phone:818-620-1532
Mailing Address - Fax:
Practice Address - Street 1:3515 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5521
Practice Address - Country:US
Practice Address - Phone:310-839-5201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39110235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist