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NPI Code Detail

MEDICARE: JONATHAN EDILSON TOBAR MORALES M.S.

MEDICARE: JONATHAN EDILSON TOBAR MORALES M.S.
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 Pathologist20216CA

General Provider Information

NPI Number : 1740749126
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN EDILSON TOBAR MORALES M.S.
Provider Business Mailing Address
First Line : 18860 NORDHOFF ST STE 100
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91324-3879
Country : US
Telephone Number : --
Fax Number :
Provider Business Practice Location Address
First Line : 18860 NORDHOFF ST STE 100
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91324-3879
Country : US
Telephone Number : --
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2019
Last Update Date : 12/09/2025

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Directions to “ JONATHAN EDILSON TOBAR MORALES M.S.” Practice Location

Language Start Address Practice Location
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