Active NPI
Amy Johnson
- Speech-Language Pathologist
- Encino, CA
National Provider Identifier
1134462930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP10583
- Practice address
- 16500 Ventura Blvd
Ste. 414
Encino, CA 91436-2011 - Phone
- (818) 788-1003
- Fax
- (818) 788-1135
- NPI assigned
- Mar 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP10583 | CA | Primary |
Addresses
Primary practice location
16500 Ventura Blvd
Ste. 414
Encino, CA 91436-2011
Mailing address
16500 Ventua Blvd.,
Ste. 414
Encino, CA 91436-5050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP 10583 | Other | CA | SPEECH PATHOLOGY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP10583 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1134462930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16500 VENTUA BLVD.,",
"address_2": "STE. 414",
"city": "ENCINO",
"state": "CA",
"postal_code": "914365050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16500 VENTURA BLVD",
"address_2": "STE. 414",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362011",
"telephone_number": "818-788-1003",
"fax_number": "818-788-1135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-29",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP10583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH PATHOLOGY",
"identifier": "SP 10583",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.