Healthcare Provider Details

I. General information

NPI: 1588581672
Provider Name (Legal Business Name): MADISON SAVANNAH MANWARRING SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADISON SAVANNAH STUART SLPA

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 S SEPULVEDA BLVD STE 1100
LOS ANGELES CA
90034-7090
US

IV. Provider business mailing address

3930 W 176TH ST
TORRANCE CA
90504-3213
US

V. Phone/Fax

Practice location:
  • Phone: 562-376-1827
  • Fax:
Mailing address:
  • Phone: 310-999-1376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: