MEDICARE: MRS. LORNA MOTEN CCC-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	15911	CA

General Provider Information

NPI Number	:	1629341300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORNA MOTEN CCC-SLP

Provider Business Mailing Address
First Line	:	1225 W 190TH ST STE 360
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-4338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	879 W 190TH ST
Second Line	:	STE 400
City	:	GARDENA
State	:	CA
Zip	:	90248-4223
Country	:	US
Telephone Number	:	213-373-4479
Fax Number	:

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

Provider Enumeration Date	:	02/10/2012
Last Update Date	:	06/22/2026

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Directions to “ MRS. LORNA MOTEN CCC-SLP” Practice Location

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