Individual provider Active NPI

Liezl Anne Macabuhay Hernandez, SLPA

  • Speech-Language Assistant
  • Laguna Hills, CA
National Provider Identifier
1073380093
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
5915 Issued in CA
Practice address
26081 Merit Cir Ste 107
Laguna Hills, CA 92653-7017
Phone
(949) 498-5100
NPI assigned
Dec 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 5915 CA Primary

Addresses

Primary practice location

26081 Merit Cir Ste 107
Laguna Hills, CA 92653-7017

Mailing address

23915 Sprig St
Mission Viejo, CA 92691-3726
Phone (714) 316-3353

Other practice location 1

1000 Calle Amanecer
San Clemente, CA 92673-6214
Phone (949) 498-5100

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

State licenses

LicenseStateTypeSpecialty
5915CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Kids Therapy Center, Inc. PastSince Dec 10, 2023 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": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1073380093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23915 SPRIG ST",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913726",
            "telephone_number": "714-316-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26081 MERIT CIR STE 107",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537017",
            "telephone_number": "949-498-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Calle Amanecer",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926736214",
            "country_code": "US",
            "telephone_number": "949-498-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LIEZL ANNE",
        "middle_name": "MACABUHAY",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "5915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.