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NPI Code Detail

MEDICARE: KATHERINE MIRA BUSI

MEDICARE: KATHERINE MIRA BUSI
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
12355S0801XSpeech-Language Assistant

General Provider Information

NPI Number : 1780270769
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MIRA BUSI
Provider Business Mailing Address
First Line : 1055 E COLORADO BLVD STE 560
Second Line :
City : PASADENA
State : CA
Zip : 91106-2380
Country : US
Telephone Number : 818-241-6780
Fax Number :
Provider Business Practice Location Address
First Line : 6800 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3835
Country : US
Telephone Number : 951-779-1966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2020
Last Update Date : 06/23/2023

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Directions to “ KATHERINE MIRA BUSI ” Practice Location

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