Evelyn Divinagracia, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18689 Issued in CA

Practice address

3002 Dow Ave
114
Tustin, CA 92780-7233

Phone

(714) 731-4668

NPI assigned

Mar 29, 2017

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

Credentials

Master of Science

Practice roles

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.

• Centra Pediatric Therapy

  • Pediatric Occupational Therapist
  • Tustin, CA
  • NPI 1902177025

  Speech-Language Pathologist

  NPD (past)
• Speech and Language Pathology Associates Inc.

  • Speech-Language Pathologist
  • Encino, CA
  • NPI 1124271614
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1104358175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 MAGNOLIA DR",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907467405",
            "telephone_number": "310-971-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 DOW AVE",
            "address_2": "114",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807233",
            "telephone_number": "714-731-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINAGRACIA",
        "first_name": "EVELYN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Thao Mi Dinh, ASW
• Thaikhanh A Dinhluu, DC
• Samantha Seaton Dino, MFT
• Dio Kim Chiropractic Corporation
• Dispatchhealth-Ca, PC
• John Djerbaka, P.T.
• Carmen C DO, COTA
• Jacqueline Thanhhuyen DO, M.D.
• Kevin T. DO, M.D.
• Peter DO, PHARMD

• Speech-Language Pathologist in Tustin, CA
• Providers in Tustin, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.