Stephanie Petersen, MS SLP CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12067442 Issued in CA

Practice address

740 Golden Ave
Placentia, CA 92870-1635

Phone

(714) 262-3175

NPI assigned

Apr 23, 2026

Last updated

Apr 23, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1776902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1154266278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 E ALDER ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216655",
            "telephone_number": "714-262-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 GOLDEN AVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701635",
            "telephone_number": "714-262-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "STEPHANIE",
        "credential": "MS SLP CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-23",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "12067442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Petreccia and Trotter Medical Corporation (Infectious Disease Consultants Med. Office, Inc.)
• Deborah Petros
• Mary Regina Pham, D.D.S., M.S.
• Peter Minh Pham
• Thao Trinh Pham, SPEECH PATHOLOGIST

• Speech-Language Pathologist in Placentia, CA
• Providers in Placentia, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.