MEDICARE: LIANE YOMOGIDA

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

General Provider Information

NPI Number	:	1861188393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANE YOMOGIDA

Provider Business Mailing Address
First Line	:	3835 GUNDRY AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3153
Country	:	US
Telephone Number	:	562-439-6244
Fax Number	:

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

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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Directions to “ LIANE YOMOGIDA ” Practice Location

Language	Start Address	Practice Location

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