MEDICARE: STEPHANIE CORDERO

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		CA

General Provider Information

NPI Number	:	1982569653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CORDERO

Provider Business Mailing Address
First Line	:	400 HAUSER BLVD APT 12F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-5524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 S GLENOAKS BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91502-1319
Country	:	US
Telephone Number	:	818-434-5120
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ STEPHANIE CORDERO ” Practice Location

Language	Start Address	Practice Location

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