Active NPI
Marisol A Acosta
- Speech-Language Pathologist
- Upland, CA
National Provider Identifier
1215769070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5720
- Practice address
- 222 N Mountain Ave Ste 109a
Upland, CA 91786-5715 - Phone
- (909) 610-9151
- NPI assigned
- Aug 19, 2024
- Last updated
- Aug 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5720 | CA | Primary |
Addresses
Primary practice location
222 N Mountain Ave Ste 109a
Upland, CA 91786-5715
Mailing address
222 N Mountain Ave Ste 109a
Upland, CA 91786-5715
Phone (909) 610-9151
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5720 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1215769070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 N MOUNTAIN AVE STE 109A",
"city": "UPLAND",
"state": "CA",
"postal_code": "917865715",
"telephone_number": "909-610-9151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 N MOUNTAIN AVE STE 109A",
"city": "UPLAND",
"state": "CA",
"postal_code": "917865715",
"telephone_number": "909-610-9151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOSTA",
"first_name": "MARISOL",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "5720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.