Provider Demographics
NPI:1730401753
Name:GUAJARDO KRALJEVIC, CAROLINA ANDREA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:ANDREA
Last Name:GUAJARDO KRALJEVIC
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 1:2160 W ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-2039
Mailing Address - Country:US
Mailing Address - Phone:213-748-5481
Mailing Address - Fax:
Practice Address - Street 1:2160 W ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-2039
Practice Address - Country:US
Practice Address - Phone:213-748-5481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASLP-16696235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty