Individual provider Active NPI

Theresa Thuy Dacio, SLP

  • Speech-Language Pathologist
  • Anaheim, CA
National Provider Identifier
1285386920
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16422 Issued in CA
Practice address
5475 E la Palma Ave Ste 206
Anaheim, CA 92807-2075
Phone
(909) 636-8125
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16422 CA Primary

Addresses

Primary practice location

5475 E la Palma Ave Ste 206
Anaheim, CA 92807-2075

Mailing address

5407 E Indian Wells CT
Anaheim, CA 92807-4613
Phone (909) 636-8125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215000316 CA Practitioner - Qualified Speech Language Pathologist 1456744465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Anaheim, CA 92807
Phone (714) 251-6356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Instrumental Speech Language Pathology Professionals Inc. Speech-Language Pathologist CurrentSince Jan 31, 2022 Accepting new patients

Locations

5475 E La Palma Ave
Ste 206
Anaheim, CA 92807
Phone (714) 251-6356

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1285386920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 E INDIAN WELLS CT",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074613",
            "telephone_number": "909-636-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 E LA PALMA AVE STE 206",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072075",
            "telephone_number": "909-636-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACIO",
        "first_name": "THERESA",
        "middle_name": "THUY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.