Trysh Sacro Libao, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

26229 Issued in CA

Practice address

3020 Childrens Way # Mc5010
San Diego, CA 92123-4223

Phone

(909) 754-0290

NPI assigned

Aug 1, 2019

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

Other names 1

• Ma Patricia Ysabel Sacro Libao Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1104471663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5010",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5010",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "909-754-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBAO",
        "first_name": "TRYSH",
        "middle_name": "SACRO",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "26229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MA PATRICIA YSABEL",
            "last_name": "LIBAO",
            "middle_name": "SACRO",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucy Liao
• Wei Cheng Liao, APCC
• Joy Liau, M.D. PH.D.
• Dana Janelle Liban-Menkes, RN
• Edgardo Cano Liban, RN
• Alicea Merete Libbey
• Christine Libbey, PH.D.
• Libby Dental
• Edward Norton Libby, MD
• Libby, Marongiu and Spencer Dental

• Speech-Language Pathologist in San Diego, CA
• Providers in San Diego, 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 Aug 1, 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.