Individual provider Active NPI

Jenna Beuck, MS CCC-SLP

  • Speech-Language Pathologist
  • Newport Beach, CA
National Provider Identifier
1063260735
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
31635 Issued in CA
Practice address
3900 Birch St Ste 103
Newport Beach, CA 92660-2226
Phone
(949) 955-0010
Fax
(949) 955-0033
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 31635 CA Primary

Addresses

Primary practice location

3900 Birch St Ste 103
Newport Beach, CA 92660-2226

Mailing address

126 E 18TH St Apt B204
Costa Mesa, CA 92627-3045
Phone (949) 648-0247

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
31635CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Therapy, Inc Single Specialty PastSince May 12, 2024 Accepting new patients

Organizations & group practices 1

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": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1063260735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E 18TH ST APT B204",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273045",
            "telephone_number": "949-648-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BIRCH ST STE 103",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602226",
            "telephone_number": "949-955-0010",
            "fax_number": "949-955-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEUCK",
        "first_name": "JENNA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "31635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.