MEDICARE: TAYLOR SONZENA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	30908	CA

General Provider Information

NPI Number	:	1295563039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR SONZENA

Provider Business Mailing Address
First Line	:	9670 EFFEN ST
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-2703
Country	:	US
Telephone Number	:	909-815-5612
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 SPRING ST
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-4930
Country	:	US
Telephone Number	:	626-986-3573
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	08/13/2024

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Directions to “ TAYLOR SONZENA ” Practice Location

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