Active NPI
Beth Ann Phillips, M.A.
- Speech-Language Pathologist
- Tarzana, CA
National Provider Identifier
1063653129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 2940
- Practice address
- 18740 Ventura Blvd
Ste 100
Tarzana, CA 91356-3366 - Phone
- (818) 774-0224
- Fax
- (818) 774-1935
- NPI assigned
- Mar 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 2940 | CA | Primary |
Addresses
Primary practice location
18740 Ventura Blvd
Ste 100
Tarzana, CA 91356-3366
Mailing address
18740 Ventura Blvd
Ste 100
Tarzana, CA 91356-3366
Phone (818) 774-0224
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 2940 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237334400000",
"number": "1063653129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18740 VENTURA BLVD",
"address_2": "STE 100",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563366",
"telephone_number": "818-774-0224",
"fax_number": "818-774-1935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18740 VENTURA BLVD",
"address_2": "STE 100",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563366",
"telephone_number": "818-774-0224",
"fax_number": "818-774-1935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "BETH",
"middle_name": "ANN",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-18",
"last_updated": "2009-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 2940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.