Active NPI
Breeana Rose Lancaster, M.A. CCC-SLP
- Speech-Language Pathologist
- San Diego, CA
National Provider Identifier
1134526874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22132
- Practice address
- 11838 Bernardo Plaza CT. Suite 110
Kids Therapy Associates,
San Diego, CA 92128 - Phone
- (858) 673-5434
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 22132 | CA | Primary |
Addresses
Primary practice location
11838 Bernardo Plaza CT. Suite 110
Kids Therapy Associates,
San Diego, CA 92128
Mailing address
11838 Bernardo Plaza CT. Suite 110
Kids Therapy Associates,
San Diego, CA 92128
Phone (858) 673-5434
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22132 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1134526874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11838 BERNARDO PLAZA CT. SUITE 110",
"address_2": "KIDS THERAPY ASSOCIATES,",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92128",
"telephone_number": "858-673-5434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11838 BERNARDO PLAZA CT. SUITE 110",
"address_2": "KIDS THERAPY ASSOCIATES,",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92128",
"telephone_number": "858-673-5434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANCASTER",
"first_name": "BREEANA",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "22132",
"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 Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.