Meghan Widerberg, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 19684 Issued in CA

Practice address

16500 Ventura Blvd Ste 414
Encino, CA 91436-5050

Phone

(818) 788-1003

Fax

(818) 788-1135

NPI assigned

Oct 18, 2012

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

Other identifiers 1

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1215280995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 CARPENTER AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916074111",
            "telephone_number": "818-788-1003",
            "fax_number": "818-788-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 VENTURA BLVD STE 414",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365050",
            "telephone_number": "818-788-1003",
            "fax_number": "818-788-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDERBERG",
        "first_name": "MEGHAN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 19684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "SP 19684",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• White Orchid Home Health
• White Rose Hospice, Inc.
• Ronald Jean White Jr.
• Justin Whitten, RD RDN
• Courtney Michel Whittington, LMFT
• Curt Ryan Widhalm, LMFT
• Miriam Wiener, MS, MPH
• Kanishka Wijegunaratne, M.D.
• Sandra Lee Wilder-Padilla, PHD
• Steven Alexander Wildgor, BCBA

• Speech-Language Pathologist in Encino, CA
• Providers in Encino, 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 Oct 22, 2012; 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.