Gwendolyn Bellezza, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP21508 Issued in CA

Practice address

1120 Via Callejon
Suite B
San Clemente, CA 92673-6213

Phone

(949) 498-5100

NPI assigned

Jan 3, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1043631336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 POPPYFIELD LN",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926888725",
            "telephone_number": "760-221-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 VIA CALLEJON",
            "address_2": "SUITE B",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736213",
            "telephone_number": "949-498-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLEZZA",
        "first_name": "GWENDOLYN",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP21508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in San Clemente, CA
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.