Individual provider Active NPI

Sammy Jo Hallis, MS, CCC-SLP

  • Speech-Language Pathologist
  • Menifee, CA
National Provider Identifier
1134071400
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP32164 Issued in CA
Practice address
29810 Wickerd Rd
Menifee, CA 92584-8228
Phone
(951) 723-3032
NPI assigned
Feb 10, 2026
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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 SP32164 CA Primary

Addresses

Primary practice location

29810 Wickerd Rd
Menifee, CA 92584-8228

Mailing address

29521 Shire Horse Way
Menifee, CA 92584-1119
Phone (951) 264-7889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP32164CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1134071400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29521 SHIRE HORSE WAY",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925841119",
            "telephone_number": "951-264-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29810 WICKERD RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848228",
            "telephone_number": "951-723-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIS",
        "first_name": "SAMMY",
        "middle_name": "JO",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP32164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.