Jillian Maria Baca, SLPA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

358258 Issued in CO

Practice address

2404 Desperado Dr
Trinidad, CO 81082-3966

Phone

(719) 680-2015

NPI assigned

Sep 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1144998527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 DESPERADO DR",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810823966",
            "telephone_number": "719-680-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 DESPERADO DR",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810823966",
            "telephone_number": "719-680-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "JILLIAN",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "358258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillian1705@hotmail.com",
            "affiliation": "N",
            "address_1": "2404 Desperado Dr",
            "city": "Trinidad",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810823966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jillian1705@hotmail.com",
            "affiliation": "N",
            "address_1": "2404 Desperado Dr",
            "city": "Trinidad",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810823966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul A Andreatta, D.D.S. P.C.
• Teresa Aragon, ABOC
• Anita Laverne Archibeque, M.A.
• Brandon G Baca, MSPT
• Heather M Baca, M.S.,ED.,CCC-SLP
• Lisa Rose Baca, COTA
• Billie Bacca
• Jerrie Dawn Bennett
• Kristy Kay Bennett, D.C.
• Jenna Benson, PTA

• Speech-Language Pathologist in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.