Provider Demographics
NPI:1780191007
Name:OMOJEMINIYI, JANELLA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANELLA
Middle Name:
Last Name:OMOJEMINIYI
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 W 221ST ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-4107
Mailing Address - Country:US
Mailing Address - Phone:213-241-9518
Mailing Address - Fax:
Practice Address - Street 1:1632 W 221ST ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-4107
Practice Address - Country:US
Practice Address - Phone:213-241-9518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist