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NPI Code Detail

MEDICARE: MARY DIANE WARDEN

MEDICARE: MARY DIANE WARDEN
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 PathologistSP5962CA

General Provider Information

NPI Number : 1417456765
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY DIANE WARDEN
Provider Business Mailing Address
First Line : 4010 BARRANCA PKWY STE 220
Second Line :
City : IRVINE
State : CA
Zip : 92604-1721
Country : US
Telephone Number : 949-857-6051
Fax Number : 949-857-0941
Provider Business Practice Location Address
First Line : 4010 BARRANCA PKWY STE 220
Second Line :
City : IRVINE
State : CA
Zip : 92604-1721
Country : US
Telephone Number : 949-857-6051
Fax Number : 949-857-0941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 02/01/2018

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Directions to “ MARY DIANE WARDEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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