Provider Demographics
NPI:1972087245
Name:MADJIDI, SADIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:MADJIDI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 W 226TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2625
Mailing Address - Country:US
Mailing Address - Phone:310-383-1516
Mailing Address - Fax:
Practice Address - Street 1:10293 BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2264
Practice Address - Country:US
Practice Address - Phone:562-799-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty