Active NPI
Connie Lee Addicks, M.A.CCC,SLP
- Speech-Language Pathologist
- Laguna Niguel, CA
National Provider Identifier
1275852261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8174
- Practice address
- 135 Chandon
Laguna Niguel, CA 92677-5732 - Phone
- (949) 280-2519
- NPI assigned
- May 31, 2010
- Last updated
- May 31, 2010
- 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 Pathologist | 235Z00000X | 8174 | CA | Primary |
Addresses
Primary practice location
135 Chandon
Laguna Niguel, CA 92677-5732
Mailing address
135 Chandon
Laguna Niguel, CA 92677-5732
Phone (949) 280-2519
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 |
|---|---|---|---|
| 8174 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275264000000",
"number": "1275852261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 CHANDON",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926775732",
"telephone_number": "949-280-2519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 CHANDON",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926775732",
"telephone_number": "949-280-2519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDICKS",
"first_name": "CONNIE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "M.A.CCC,SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-31",
"last_updated": "2010-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "8174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.