Healthcare Provider Details

I. General information

NPI: 1699988451
Provider Name (Legal Business Name): MONA ABEDZADEH M.A CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

1026 S REXFORD LN
ANAHEIM CA
92808-2334
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-5082
  • Fax:
Mailing address:
  • Phone: 714-401-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number15477
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: