King Speech Pathology Services, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KING SPEECH PATHOLOGY SERVICES, INC.

Doing business as

Functional Cognitive Rehab

Practice address

4079 Governor Dr # 5072
San Diego, CA 92122-2522

Phone

(209) 585-6299

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Tyler King, MS, CCC-SLPNPI 1528603826

Title

Owner

Phone

(209) 585-6299

Specialties & licenses 1

Addresses

Other names 1

• Functional Cognitive Rehab Doing business as

Practitioners 1

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

• Tyler King, M.S., CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1528603826
  NPD Authorized official

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1275250508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4079 GOVERNOR DR # 5072",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 GOVERNOR DR # 5072",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222522",
            "telephone_number": "209-585-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING SPEECH PATHOLOGY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-585-6299",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Cognitive Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosalina Lucero Kiner, PHARMACY TECHNICIAN
• Kinetic Chiropractic
• Kinetic Dynamics LLC (Compression Health)
• King Home Care Corporation (BrightStar Care of N. Central San Diego)
• King One Transportation LLC
• King-Chavez Community High School
• Alan Vincent King Jr., IDC
• Amanda King
• Arielle Elizabeth King, BCBA
• Ashley Ayn King

• Speech-Language Pathologist in San Diego, CA
• Providers in San Diego, 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 Jun 17, 2024; 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.