Individual provider Active NPI

Stephanie Masek, MS CCC-SLP

  • Speech-Language Pathologist
  • Pasadena, CA
National Provider Identifier
1124445788
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
24330 Issued in CA
Practice address
1898 Santa Rosa Ave
Pasadena, CA 91104-1131
Phone
(626) 824-1204
NPI assigned
Mar 20, 2014
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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 24330 CA Primary

Addresses

Primary practice location

1898 Santa Rosa Ave
Pasadena, CA 91104-1131

Mailing address

1898 Santa Rosa Ave
Pasadena, CA 91104-1131
Phone (626) 824-1204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002314 CA Practitioner - Qualified Speech Language Pathologist 5496144057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
24330CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jabberdogs Speech-Language Pathologist CurrentSince Sep 9, 2021 Accepting new patients

Locations

415 Huntington Dr
Ste 102
San Marino, CA 91108
Phone (323) 835-4640

Organizations & group practices 1

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": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1124445788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 SANTA ROSA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041131",
            "telephone_number": "626-824-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 SANTA ROSA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041131",
            "telephone_number": "626-824-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASEK",
        "first_name": "STEPHANIE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.