Provider Demographics
NPI:1710570296
Name:CARROTT, LONDON N (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LONDON
Middle Name:N
Last Name:CARROTT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LONDON
Other - Middle Name:N
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:365 E AVENIDA DE LOS ARBOLES # B101
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2975
Mailing Address - Country:US
Mailing Address - Phone:805-404-5800
Mailing Address - Fax:
Practice Address - Street 1:365 E AVENIDA DE LOS ARBOLES # B101
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2975
Practice Address - Country:US
Practice Address - Phone:805-390-9603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist