Individual provider Active NPI

Soleil Skyler Black, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Lake Forest, CA
National Provider Identifier
1043824865
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
38135 Issued in CA
Practice address
22672 Lambert St Ste 611
Lake Forest, CA 92630-1613
Phone
(949) 329-8161
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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 38135 CA Primary

Addresses

Primary practice location

22672 Lambert St Ste 611
Lake Forest, CA 92630-1613

Mailing address

22672 Lambert St Ste 611
Lake Forest, CA 92630-1613
Phone (949) 329-8161

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
38135CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Speech Therapy Corp Speech-Language Pathologist CurrentSince Sep 21, 2025 Accepting new patients
Sutter Valley Hospitals PastSince Sep 21, 2025 Accepting new patients

Locations

22672 Lambert St
Ste 611
Lake Forest, CA 92630
Phone (949) 329-8161

Organizations & group practices 2

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1043824865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22672 LAMBERT ST STE 611",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301613",
            "telephone_number": "949-329-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22672 LAMBERT ST STE 611",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301613",
            "telephone_number": "949-329-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SOLEIL",
        "middle_name": "SKYLER",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "38135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.