Samantha Tan, M.S. CCC-SLP, CLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

400 W Ventura Blvd Ste 150
Camarillo, CA 93010-9140

Phone

(805) 383-1497

Fax

(805) 383-1498

NPI assigned

Mar 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Rabls Inc

  • Speech-Language Pathologist
  • Camarillo, CA
  • NPI 1871946897

  Lactation Consultant, Non-RN

  NPD (past)
• Rabls Inc

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1922668706
  NPD (past)

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1114485570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12168 MONOGRAM AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W VENTURA BLVD STE 150",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930109140",
            "telephone_number": "805-383-1497",
            "fax_number": "805-383-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "SAMANTHA",
        "credential": "M.S. CCC-SLP, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Eskuri Taluy
• Jordain Taylor Tamai
• Kurt Tamaru, M.D.
• Susana Madeline Tamayo
• Rycelonia Tan, RN
• Michael Tanner
• Christina Pualani Tanouye, O.D.
• Tao Family Chiropractic, Inc.
• Michinori Tao, DC
• Julia Tarver, RN

• Speech-Language Pathologist in Camarillo, CA
• Providers in Camarillo, 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 Oct 11, 2022; 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.