NPIMap

Organization Active NPI

Associated Speech Pathologists

  • Speech-Language Pathologist
  • San Marcos, CA
National Provider Identifier
1225167646
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP4920 Issued in CA
Legal business name
ASSOCIATED SPEECH PATHOLOGISTS
Practice address
1595 Grand Ave
Suite 110
San Marcos, CA 92078-2450
Phone
(760) 471-1198
Fax
(760) 471-5657
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Mary Anne Maclellan, M.A., CCC, SLPNPI 1053440479
Title
Speech-Language Pathologist Owner
Phone
(760) 471-1198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP4920 CA Primary

Addresses

Primary practice location

1595 Grand Ave
Suite 110
San Marcos, CA 92078-2450

Mailing address

1595 Grand Ave
Suite 110
San Marcos, CA 92078-2450
Phone (760) 471-1198

Other identifiers 1

IdentifierTypeStateIssuer
SP0049200MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211129001219 CA Part B Supplier - Clinic/Group Practice 7719377126 Receives reassigned benefits from 1 practitioner
Practice locations: San Marcos, CA

National Provider Directory

National Provider Directory

Locations

1595 Grand Ave
Ste 110
San Marcos, CA 92078
Phone (760) 471-1198

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1225167646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE",
            "address_2": "SUITE 110",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-471-1198",
            "fax_number": "760-471-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE",
            "address_2": "SUITE 110",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-471-1198",
            "fax_number": "760-471-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED SPEECH PATHOLOGISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "MACLELLAN",
        "authorized_official_first_name": "MARY ANNE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST OWNER",
        "authorized_official_telephone_number": "760-471-1198",
        "authorized_official_credential": "M.A., CCC, SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP4920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP0049200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.