Healthcare Provider Details

I. General information

NPI: 1891281515
Provider Name (Legal Business Name): NATTERINGS SPEECH & LANGUAGE PATHOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W 6TH ST STE 210
LOS ANGELES CA
90020-2576
US

IV. Provider business mailing address

355 S MANSFIELD AVE
LOS ANGELES CA
90036-3058
US

V. Phone/Fax

Practice location:
  • Phone: 310-347-5812
  • Fax:
Mailing address:
  • Phone: 213-503-4878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17475
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3981
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number895
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21264
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DA CHO
Title or Position: COO
Credential:
Phone: 213-503-4878