Individual provider Active NPI

Reisha Golden, SLP

  • Speech-Language Pathologist
  • Long Beach, CA
National Provider Identifier
1073904967
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
23664 Issued in CA
Practice address
4401 Atlantic Avenue Suite 200
Long Beach, CA 90807-6015
Phone
(714) 614-1316
Fax
(562) 318-3050
NPI assigned
Feb 12, 2015
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 23664 CA Primary

Addresses

Primary practice location

4401 Atlantic Avenue Suite 200
Long Beach, CA 90807-6015

Mailing address

4401 Atlantic Ave Ste 200
Long Beach, CA 90807-2264
Phone (714) 614-1316

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

State licenses

LicenseStateTypeSpecialty
23664CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reisha Golden CCC-SLP Speech-Language Pathologist PastSince Aug 16, 2017 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1073904967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVE STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072264",
            "telephone_number": "714-614-1316",
            "fax_number": "833-963-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVENUE SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076015",
            "telephone_number": "714-614-1316",
            "fax_number": "562-318-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "REISHA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "23664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.