Elisabeth Anne Balcom, M.A.,CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP16633 Issued in CA

Practice address

12778 Road 37 1/2
Madera, CA 93636-8757

Phone

(559) 430-8239

NPI assigned

Jan 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Betsy Jorgensen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1124485495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12778 ROAD 37 1/2",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368757",
            "telephone_number": "559-430-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCOM",
        "first_name": "ELISABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "M.A.,CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP16633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "JORGENSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Simrin Kaur Bains
• Katherine Baker, CPNP
• Bakht Roshan MD, a Professional Corp
• Vinod V Balasa, M.D.
• Blake Elizzabeth Balbas
• Emily Baldwin, RN, PHN
• Darlene Catherine Ball, MSN-PNP
• Keyry Ballesteros
• Jose A Balsells Jr.
• Swati Banerjee, M.D.

• Speech-Language Pathologist in Madera, CA
• Providers in Madera, 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 Dec 13, 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.