Provider Demographics
NPI:1568847978
Name:KPADUWA, CORDELIA (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:CORDELIA
Middle Name:
Last Name:KPADUWA
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 FLORENCE AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3672
Mailing Address - Country:US
Mailing Address - Phone:562-928-8006
Mailing Address - Fax:562-928-8261
Practice Address - Street 1:7340 FLORENCE AVE STE 219
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3672
Practice Address - Country:US
Practice Address - Phone:562-928-8006
Practice Address - Fax:562-928-8261
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95049418163W00000X
CA11579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist