Heidi Linette Bolanos

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

Practice address

13066 Van Nuys Blvd
Pacoima, CA 91331-2576

Phone

(818) 206-8217

NPI assigned

Mar 28, 2018

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Easy Speech Pathology, Inc.

  • Multi-Specialty Clinic/Center
  • Palm Desert, CA
  • NPI 1124434261

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1013412337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13066 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913312576",
            "telephone_number": "818-206-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13066 VAN NUYS BLVD",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913312576",
            "telephone_number": "818-206-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "HEIDI",
        "middle_name": "LINETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Bivian
• Blanc Medical Supplies
• Blanc Medical Supplies Inc
• Marie Bohui
• Ana Bolanos
• Michael Bonilla
• Loretta Botello
• Melissa Diane Boudin, PSY.D.
• Destiny Dawn Bowie
• Arden Boykin

• All providers in Pacoima, CA
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.