Individual provider Active NPI

Jaclyn Marie Shasha, M.S.

  • Hearing and Speech Clinic/Center
  • Murrieta, CA
National Provider Identifier
1265779979
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
21834
Practice address
41176 Guava St. Suite a
Murrieta, CA 92562
Phone
(951) 660-2961
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 21834 CA
Hearing and Speech Clinic/Center 261QH0700X 21834 Primary
Specialist 174400000X

Addresses

Primary practice location

41176 Guava St. Suite a
Murrieta, CA 92562

Mailing address

40055 Tinderbox Way
Murrieta, CA 92562
Phone (951) 660-2961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250530002453 CA Practitioner - Qualified Speech Language Pathologist 6103140330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

41197 Golden Gate Cir
Suite 103
Murrieta, CA 92562-6998
Phone (909) 654-4062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Speech Therapy Solutions, Inc Speech-Language Pathologist CurrentSince Apr 16, 2025 Accepting new patients

Locations

41197 Golden Gate Cir
Ste 103
Murrieta, CA 92562
Phone (909) 654-4062

41176 Guava St
Ste A
Murrieta, CA 92562
Phone (909) 654-4062

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1265779979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40055 TINDERBOX WAY",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-660-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41176 GUAVA ST. SUITE A",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-660-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASHA",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "21834",
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": "21834",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.