NPIMap

Organization Active NPI

Providence Speech and Hearing Center

  • Speech-Language Pathologist
  • Fountain Valley, CA
National Provider Identifier
1083264196
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PROVIDENCE SPEECH AND HEARING CENTER
Practice address
17075 Bushard St
Fountain Valley, CA 92708-2836
Phone
(855) 901-7742
NPI assigned
Sep 19, 2019
Last updated
Sep 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Authorized official

Name
Valentina Cedeno
Title
Credentialing/Human Resources
Phone
(715) 639-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

17075 Bushard St
Fountain Valley, CA 92708-2836

Mailing address

3301 Michelson Dr Apt 3303
Irvine, CA 92612-4320
Phone (909) 896-3003

National Provider Directory

National Provider Directory

Locations

10221 Slater Ave
Ste 115
Fountain Valley, CA 92708
Phone (714) 964-9277

19582 Beach Blvd
Ste 110
Huntington Beach, CA 92648
Phone (714) 602-2790

520 Superior Ave
Ste 190
Newport Beach, CA 92663
Phone (714) 639-4991

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1083264196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 MICHELSON DR APT 3303",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926124320",
            "telephone_number": "909-896-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082836",
            "telephone_number": "855-901-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SPEECH AND HEARING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "CEDENO",
        "authorized_official_first_name": "VALENTINA",
        "authorized_official_title_or_position": "CREDENTIALING/HUMAN RESOURCES",
        "authorized_official_telephone_number": "715-639-4990"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.