Active NPI
Leslie Yesenia Medrano, SPA
- Speech-Language Assistant
- Encino, CA
National Provider Identifier
1225431398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 2862
- Practice address
- 16500 Ventura Blvd
Suite 414
Encino, CA 91436-2011 - Phone
- (818) 788-1003
- NPI assigned
- Oct 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | 2862 | CA | Primary |
Addresses
Primary practice location
16500 Ventura Blvd
Suite 414
Encino, CA 91436-2011
Mailing address
7444 Woodman Ave
240
Van Nuys, CA 91405-1561
Phone (209) 409-4650
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 |
|---|---|---|---|
| 2862 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1225431398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7444 WOODMAN AVE",
"address_2": "240",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051561",
"telephone_number": "209-409-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16500 VENTURA BLVD",
"address_2": "SUITE 414",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362011",
"telephone_number": "818-788-1003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDRANO",
"first_name": "LESLIE",
"middle_name": "YESENIA",
"credential": "SPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "2862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.