Tanyia Khadem, MA. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-15029 Issued in CA

Practice address

1600 E Foothill Blvd
Glendora, CA 91741-3024

Phone

(626) 963-5731

NPI assigned

Mar 19, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• D'Veal Family and Youth Services

  • Community/Behavioral Health Agency
  • Glendora, CA
  • NPI 1083262513
  NPD (past)

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1801744313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 BRADFORD CT",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863419",
            "telephone_number": "909-772-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413024",
            "telephone_number": "626-963-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADEM",
        "first_name": "TANYIA",
        "credential": "MA. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP-15029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raeda Kassar, DDS
• Samuel Kassar, MD
• Keke Zheng & Company Anesthesia, a Professional Corporation
• Ken C. Tan, M.D.
• Debra Sue Key, FNP, PHN, RN
• Waseem Ekram Sedhom Khalil, RPH
• Ayesha Khan Hawkins, M.S.P.T.
• Naveed Abas Khan, MD
• Nida Kichkla, NP
• Kathleen Kiely, RPH

• Speech-Language Pathologist in Glendora, CA
• Providers in Glendora, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.