NPIMap

Organization Active NPI

San Diego County Speech Pathology Services, Inc

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1205092053
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1579 Issued in CA
Legal business name
SAN DIEGO COUNTY SPEECH PATHOLOGY SERVICES, INC
Practice address
411 Camino del Rio S
101
San Diego, CA 92108-3530
Phone
(619) 574-8181
Fax
(619) 574-0802
NPI assigned
Jul 31, 2008
Last updated
Jan 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Authorized official

Name
Ms. Judy L Lewis
Title
Office Manager
Phone
(619) 574-8181

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP1579 CA Primary
Preferred Provider Organization 305R00000X SP1579 CA

Addresses

Primary practice location

411 Camino del Rio S
101
San Diego, CA 92108-3530

Mailing address

411 Camino del Rio S
101
San Diego, CA 92108-3530
Phone (619) 574-8181

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1205092053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CAMINO DEL RIO S",
            "address_2": "101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083530",
            "telephone_number": "619-574-8181",
            "fax_number": "619-574-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CAMINO DEL RIO S",
            "address_2": "101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083530",
            "telephone_number": "619-574-8181",
            "fax_number": "619-574-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO COUNTY SPEECH PATHOLOGY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-574-8181",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP1579",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "SP1579",
            "primary": false
        }
    ],
    "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 25, 2019; 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.