Healthcare Provider Details

I. General information

NPI: 1982528683
Provider Name (Legal Business Name): OAK GROVE SPEECH THERAPY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 S LAKE AVE STE 655
PASADENA CA
91101-2594
US

IV. Provider business mailing address

1470 LINDA VISTA AVE
PASADENA CA
91103-1951
US

V. Phone/Fax

Practice location:
  • Phone: 323-739-8119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMY ONDERDONK
Title or Position: CEO/PRESIDENT
Credential: MS, CCC-SLP, CLES
Phone: 323-739-8119