Individual provider Active NPI

Scott W Calderwood

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1134433899
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP18894 Issued in CA
Practice address
4010 Morena Blvd Ste 103
San Diego, CA 92117-4547
Phone
(619) 356-1315
Fax
(619) 860-1270
NPI assigned
Aug 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X RPE6269 CA
Speech-Language Pathologist 235Z00000X SP18894 CA Primary

Addresses

Primary practice location

4010 Morena Blvd Ste 103
San Diego, CA 92117-4547

Mailing address

501 W Broadway Ste 800
San Diego, CA 92101-3546
Phone (619) 356-1315

Other practice location 1

405 Alberto Way
Suite D&E
Los Gatos, CA 95032-5406
Phone (877) 991-0009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401001859 CA Practitioner - Qualified Speech Language Pathologist 7012438567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RPE6269CAMDSpeech-Language Pathologist
SP18894CAMDSpeech-Language Pathologist
18894CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
J & S Pediatric Therapy, P.C. Speech-Language Pathologist CurrentSince Mar 10, 2025 Accepting new patients

Locations

501 W Broadway
Ste 800
San Diego, CA 92101
Phone (619) 400-4943

3660 Clairemont Dr
Ste 2
San Diego, CA 92117
Phone (619) 356-1315

4010 Morena Blvd
Ste 103
San Diego, CA 92117
Phone (619) 356-1315

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1134433899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013546",
            "telephone_number": "619-356-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MORENA BLVD STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921174547",
            "telephone_number": "619-356-1315",
            "fax_number": "619-860-1270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Alberto Way",
            "address_2": "Suite D&E",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950325406",
            "country_code": "US",
            "telephone_number": "877-991-0009",
            "fax_number": "877-991-0009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDERWOOD",
        "first_name": "SCOTT",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "RPE6269",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP18894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.