Healthcare Provider Details

I. General information

NPI: 1104750850
Provider Name (Legal Business Name): JONI MARUMOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 182ND ST
TORRANCE CA
90504-4837
US

IV. Provider business mailing address

714 N GUADALUPE AVE # 2
REDONDO BEACH CA
90277-2257
US

V. Phone/Fax

Practice location:
  • Phone: 310-533-4513
  • Fax:
Mailing address:
  • Phone: 310-435-1487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP10250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: