Yvonne Marie San Juan, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLPS482 Issued in AK

Practice address

4241 B St Ste 301
Anchorage, AK 99503-5920

Phone

(907) 727-0935

Fax

(907) 276-7529

NPI assigned

Apr 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Yvonne Marie Ellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Achieve Speech Therapy LLC

  • Speech-Language Pathologist
  • Anchorage, AK
  • NPI 1881224236
  NPD Authorized official
• Dynamic OT

  • Occupational Therapist
  • Anchorage, AK
  • NPI 1811460249
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1023437332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 B ST STE 301",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035920",
            "telephone_number": "907-727-0935",
            "fax_number": "907-276-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 B ST STE 301",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035920",
            "telephone_number": "907-727-0935",
            "fax_number": "907-276-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN JUAN",
        "first_name": "YVONNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "482",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "SLPS482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1610921",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YVONNE",
            "last_name": "ELLIS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol Lee Samuelson, PT
• Lisa K Samuelson, CRT
• Rachel Alice Samuelson, MD
• Timothy V Samuelson, MD
• Rex San Diego, LPN
• Erin Eve Sanborn, OTD, OTR/L
• Ellen Gregory Sanchez, CDC I
• Emily Cutting Sanchez, PT, DPT, GCS
• Evelia Sanchez
• Fernanda Sanchez

• Speech-Language Pathologist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Speech-Language Pathologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.