Provider Demographics
NPI:1730542556
Name:SHAVER-SCHENKER, RADNA TALITA
Entity type:Individual
Prefix:
First Name:RADNA
Middle Name:TALITA
Last Name:SHAVER-SCHENKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23411 SUMMERFIELD DRIVE
Mailing Address - Street 2:APT 18 E
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:714-408-6433
Mailing Address - Fax:
Practice Address - Street 1:18103 SKY PARK CIR
Practice Address - Street 2:SUITE A
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6512
Practice Address - Country:US
Practice Address - Phone:949-573-0873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22522355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant