MEDICARE: SHAUDAI LOVE

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	21021	CA

General Provider Information

NPI Number	:	1881557577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUDAI LOVE

Provider Business Mailing Address
First Line	:	8457 ETIWANDA AVE APT H
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-9643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7828 HAVEN AVE
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-3049
Country	:	US
Telephone Number	:	909-451-8521
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ SHAUDAI LOVE ” Practice Location

Language	Start Address	Practice Location

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