Individual provider Active NPI

Samantha Lynn McComb, SLP

  • Speech-Language Pathologist
  • Mission Viejo, CA
National Provider Identifier
1104005289
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP16487 Issued in CA
Practice address
23361 Madero
Suite 200
Mission Viejo, CA 92691-2715
Phone
(949) 581-8239
Fax
(949) 859-0849
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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 SP16487 CA Primary

Addresses

Primary practice location

23361 Madero
Suite 200
Mission Viejo, CA 92691-2715

Mailing address

19081 Lindsay LN
Huntington Beach, CA 92646-2245
Phone (949) 599-0218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161020002431 CA Practitioner - Qualified Speech Language Pathologist 9739467085 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP16487CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital of Orange County CurrentSince Jul 19, 2022 Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients
Newport Language and Speech Centers Speech-Language Pathologist Past Accepting new patients
Providence Speech and Hearing Center Speech-Language Pathologist Past Accepting new patients

Locations

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Organizations & group practices 4

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1104005289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19081 LINDSAY LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926462245",
            "telephone_number": "949-599-0218",
            "fax_number": "949-859-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23361 MADERO",
            "address_2": "SUITE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912715",
            "telephone_number": "949-581-8239",
            "fax_number": "949-859-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMB",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP16487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.