Mary Anne Maclellan, M.A., CCC, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP4920 Issued in CA

Practice address

1595 Grand Ave
Suite 110
San Marcos, CA 92078-2450

Phone

(760) 471-1198

Fax

(760) 471-5657

NPI assigned

Mar 2, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Associated Speech Pathologists

  • Speech-Language Pathologist
  • San Marcos, CA
  • NPI 1225167646
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1053440479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE",
            "address_2": "SUITE 110",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-471-1198",
            "fax_number": "760-471-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE",
            "address_2": "SUITE 110",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-471-1198",
            "fax_number": "760-471-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLELLAN",
        "first_name": "MARY ANNE",
        "credential": "M.A., CCC, SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP4920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP0049200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aiyana Machado
• Mariana Machaen Morales
• Alissa Marie Macias, MSN FNP-BC
• Hector Macias
• Rosa Lee Mackinnon, SLP
• Elicia Maese
• Erica Renee Maestas
• Diana Magadan
• Libni R Magana
• Nydia Magana

• Speech-Language Pathologist in San Marcos, CA
• Providers in San Marcos, 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 Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.