Healthcare Provider Details

I. General information

NPI: 1457117228
Provider Name (Legal Business Name): TANYA BHARDWAJ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16700 NORWALK BLVD
CERRITOS CA
90703-1838
US

IV. Provider business mailing address

1 ENSUENO E
IRVINE CA
92620-1844
US

V. Phone/Fax

Practice location:
  • Phone: 562-926-5566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8018
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: