MEDICARE: MRS. DEVORAH AMY AHARON SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP20176	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP20176	OTHER	CA	SPEECH THERAPY

General Provider Information

NPI Number	:	1598001976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEVORAH AMY AHARON SLP

Provider Business Mailing Address
First Line	:	9007 CRESTA DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-4114
Country	:	US
Telephone Number	:	310-497-4668
Fax Number	:

Provider Business Practice Location Address
First Line	:	9007 CRESTA DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-4114
Country	:	US
Telephone Number	:	310-497-4668
Fax Number	:	818-788-1135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	11/10/2020

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