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NPI 1316868417

NPI 1316868417 : MIRANDA THOMAS SLP : LOS ALAMITOS, CA

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General NPI Number Information
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    NPI Number           |    1316868417
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    Entity Type          |    Individual 
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    Provider Name        |    MIRANDA THOMAS SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/23/2026
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    Last Update Date     |    07/23/2026
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Provider Practice Location Address
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    Address Line         |    10293 BLOOMFIELD ST 
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    City                 |    LOS ALAMITOS
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    State                |    CA
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    Zip                  |    90720-2264
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    Country              |    US
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    Telephone            |    562-799-4700
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    25501 PINATA CIR 
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    City                 |    MISSION VIEJO
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    State                |    CA
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    Zip                  |    92691-5450
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    40736
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    License Number State |    CA
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