Individual provider Active NPI

Diane Motamed, MS, CCC-SLP

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1174094767
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
26566 Issued in CA
Practice address
2023 S Westgate Ave
Los Angeles, CA 90025-6118
Phone
(818) 800-9295
NPI assigned
Dec 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 26566 CA Primary

Addresses

Primary practice location

2023 S Westgate Ave
Los Angeles, CA 90025-6118

Mailing address

2023 S Westgate Ave
Los Angeles, CA 90025-6118
Phone (818) 800-9295

Other practice location 1

200 Ucla Medical Plz Ste 540
Los Angeles, CA 90095-8344
Phone (310) 825-5721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
26566CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1174094767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 S WESTGATE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256118",
            "telephone_number": "818-800-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 S WESTGATE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256118",
            "telephone_number": "818-800-9295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Ucla Medical Plz Ste 540",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958344",
            "country_code": "US",
            "telephone_number": "310-825-5721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTAMED",
        "first_name": "DIANE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-08",
        "last_updated": "2022-06-27",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "26566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.