Provider Demographics
NPI:1629424338
Name:PEDONE, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:PEDONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 LOMITA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5039
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3521 LOMITA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5039
Practice Address - Country:US
Practice Address - Phone:310-856-8528
Practice Address - Fax:310-856-8532
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 35512355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant