Audrene Untalan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

38930 Issued in CA

Practice address

13223 Black Mountain Rd # 1508
San Diego, CA 92129-2698

Phone

(858) 753-5082

NPI assigned

May 21, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Radiant Speech Therapy, Inc.

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1275010548
  NPD

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1093507477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD # 1508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292698",
            "telephone_number": "858-753-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNTALAN",
        "first_name": "AUDRENE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "38930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Kristin Unruh, RN
• Jason Unruh, PA-C
• Jason Unruh, LMFT
• Unscripted Learning
• Nicole Jacquelyn Unsworth, LMFT
• Stephen Unterberg, MD
• Upac Addiction Treatment and Recovery Center
• Upac Teen Recovery Center
• Upac TRC
• Upac TRC

• All providers in San Diego, CA
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.