Individual provider Active NPI

Mickenly Doyle

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1073476487
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
39751 Issued in CA
Practice address
3634 7TH Ave Unit 2D
San Diego, CA 92103-4344
Phone
(253) 370-9392
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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 39751 CA Primary

Addresses

Primary practice location

3634 7TH Ave Unit 2D
San Diego, CA 92103-4344

Mailing address

3634 7TH Ave Unit 2D
San Diego, CA 92103-4344
Phone (253) 370-9392

Other practice location 1

4100 Normal St
San Diego, CA 92103-2653
Phone (619) 725-5501

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
39751CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1073476487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 7TH AVE UNIT 2D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034344",
            "telephone_number": "253-370-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3634 7TH AVE UNIT 2D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034344",
            "telephone_number": "253-370-9392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Normal St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032653",
            "country_code": "US",
            "telephone_number": "619-725-5501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "MICKENLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "39751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.