NPIMap

Organization Active NPI

Stacy Payne Speech Pathology, Inc

  • Hearing and Speech Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1144510413
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
SP9299 Issued in CA
Legal business name
STACY PAYNE SPEECH PATHOLOGY, INC
Practice address
11965 Venice Blvd Ste 404
Los Angeles, CA 90066-3978
Phone
(310) 562-0187
Fax
(310) 566-7697
NPI assigned
Apr 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Mrs. Stacy Payne, M.S., CCC-SLPNPI 1780985200
Title
Owner
Phone
(310) 562-0187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X SP9299 CA Primary

Addresses

Primary practice location

11965 Venice Blvd Ste 404
Los Angeles, CA 90066-3978

Mailing address

11965 Venice Blvd Ste 404
Los Angeles, CA 90066-3978
Phone (310) 562-0187

National Provider Directory

National Provider Directory

Locations

11965 Venice Blvd
Ste 404
Los Angeles, CA 90066
Phone (310) 562-0187

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1144510413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11965 VENICE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663978",
            "telephone_number": "310-562-0187",
            "fax_number": "310-566-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11965 VENICE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663978",
            "telephone_number": "310-562-0187",
            "fax_number": "310-566-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY PAYNE SPEECH PATHOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-562-0187",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "CA",
            "license": "SP9299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.