Providence Speech & Hearing Center

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PROVIDENCE SPEECH & HEARING CENTER

Practice address

1301 W Providence Ave
Orange, CA 92868-3808

Phone

(714) 639-4990

Fax

(714) 744-3841

NPI assigned

Apr 24, 2006

Organization subpart

No

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

Authorized official

Name

Mariam Elqura

Title

Contract Manager

Phone

(714) 509-3000

Specialties & licenses 6

Addresses

Other identifiers 6

Other names 1

• Providence Speech and Hearing Center Other name

Locations

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1215993704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-3000",
            "fax_number": "714-744-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W PROVIDENCE AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683808",
            "telephone_number": "714-639-4990",
            "fax_number": "714-744-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SPEECH & HEARING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "ELQURA",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "714-509-3000"
    },
    "taxonomies": [
        {
            "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": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD SPEECH",
            "identifier": "ZZZ01182Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GAU000910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OT",
            "identifier": "ZZZ05424Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSP000640",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD AUDIO",
            "identifier": "ZZZ02320Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HEARING AID",
            "identifier": "ZZZ43525Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Speech and Hearing Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Providence Speech and Hearing Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carolyn Elayne Protter, CNM
• Ernest Proud Jr., PH.D.
• Providence - Cardiology
• Providence Medical Foundation
• Providence Specialty Surgery Center LLC
• Providence Speech and Hearing Center
• Providence Speech and Hearing Center
• Providence Speech and Hearing Center
• Alma Prudencio
• Erin Allison Pruitt

• Speech-Language Pathologist in Orange, CA
• Providers in Orange, 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 14, 2022; 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.