Active NPI
Gesina Pagan, SLP
- Speech-Language Pathologist
- San Jose, CA
National Provider Identifier
1255792297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22476
- Practice address
- 4010 Moorpark Ave
117
San Jose, CA 95117-4101 - Phone
- (208) 249-0770
- NPI assigned
- Mar 18, 2016
- 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 | 22476 | CA | Primary |
Addresses
Primary practice location
4010 Moorpark Ave
117
San Jose, CA 95117-4101
Mailing address
4010 Moorpark Ave
117
San Jose, CA 95117-4101
Phone (208) 249-0770
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 |
|---|---|---|---|
| 22476 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1255792297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 MOORPARK AVE",
"address_2": "117",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951174101",
"telephone_number": "208-249-0770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 MOORPARK AVE",
"address_2": "117",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951174101",
"telephone_number": "208-249-0770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGAN",
"first_name": "GESINA",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-18",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "22476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.