Individual provider Active NPI

Susan Terwilliger Carpenter, M.S., CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1194902866
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16019 Issued in CA
Practice address
11665 Avena PL Ste 106
San Diego, CA 92128-2427
Phone
(858) 673-5437
NPI assigned
Jan 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16019 CA Primary

Addresses

Primary practice location

11665 Avena PL Ste 106
San Diego, CA 92128-2427

Mailing address

11422 Grassy Trail Dr
San Diego, CA 92127-2339
Phone (858) 716-9507

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 Science

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1194902866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11422 GRASSY TRAIL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272339",
            "telephone_number": "858-716-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 AVENA PL STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282427",
            "telephone_number": "858-673-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "SUSAN",
        "middle_name": "TERWILLIGER",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16019",
            "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 Jan 24, 2008; 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.