Provider Demographics
NPI:1043584873
Name:OZDOBA, ADI S (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ADI
Middle Name:S
Last Name:OZDOBA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ADI
Other - Middle Name:
Other - Last Name:HASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:111 SOURCE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1370
Mailing Address - Country:US
Mailing Address - Phone:949-939-4412
Mailing Address - Fax:
Practice Address - Street 1:1015 WILSHIRE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2415
Practice Address - Country:US
Practice Address - Phone:213-607-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19843235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist