Organization Active NPI

Heritage Speech Therapy Inc

  • Hearing and Speech Clinic/Center
  • Irvine, CA
National Provider Identifier
1104621846
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
HERITAGE SPEECH THERAPY INC
Practice address
17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405
Phone
(949) 771-5881
Fax
(949) 271-4904
NPI assigned
Feb 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Jonathan Nguyen
Title
Registered Agent
Phone
(949) 771-5881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X Primary

Addresses

Primary practice location

17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405

Mailing address

17802 Sky Park Cir Ste 104
Irvine, CA 92614-6405
Phone (949) 771-5881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250621000241 CA Part B Supplier - Clinic/Group Practice 6406368968 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Ana, CA

National Provider Directory

National Provider Directory

Locations

17802 Sky Park Cir
Ste 104
Irvine, CA 92614
Phone (949) 771-5881

1524 Brookhollow Dr
Ste A100
Santa Ana, CA 92705
Phone (949) 771-5881

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1104621846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17802 SKY PARK CIR STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146405",
            "telephone_number": "949-771-5881",
            "fax_number": "949-271-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17802 SKY PARK CIR STE 104",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146405",
            "telephone_number": "949-771-5881",
            "fax_number": "949-271-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE SPEECH THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "949-771-5881"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.