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NPI Code Detail

MEDICARE: DEANNA TERAMOTO M.S., CCC-SLP

MEDICARE: DEANNA TERAMOTO M.S., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist15812CA

General Provider Information

NPI Number : 1417190406
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA TERAMOTO M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1055 E COLORADO BLVD STE 560
Second Line :
City : PASADENA
State : CA
Zip : 91106-2380
Country : US
Telephone Number : 818-241-6780
Fax Number : 818-241-6853
Provider Business Practice Location Address
First Line : 5312 BOLSA AVE STE 105
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-1060
Country : US
Telephone Number : 714-965-2324
Fax Number : 714-965-2684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2009
Last Update Date : 08/05/2020

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Directions to “ DEANNA TERAMOTO M.S., CCC-SLP” Practice Location

Language Start Address Practice Location
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