Individual provider Active NPI

Brenda Joy Haaksma, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Trabuco Canyon, CA
National Provider Identifier
1285857227
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01109430 Issued in MI
Practice address
19501 Misty Ridge LN
Trabuco Canyon, CA 92679-1602
Phone
(616) 745-8308
NPI assigned
Apr 10, 2007
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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 01109430 MI Primary
Speech-Language Pathologist 235Z00000X 33135 CA
Speech-Language Pathologist 235Z00000X SLP.0000730 CO

Addresses

Primary practice location

19501 Misty Ridge LN
Trabuco Canyon, CA 92679-1602

Mailing address

19501 Misty Ridge LN
Trabuco Canyon, CA 92679-1602
Phone (616) 745-8308

Other identifiers 1

IdentifierTypeStateIssuer
99556502MedicaidCO

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SLP.0000730COMDSpeech-Language Pathologist
01109430MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
No Boundaries Remote Solutions LLC Speech-Language Pathologist CurrentSince Feb 19, 2023 Accepting new patients
Haaksma Speech Pathology, LLC Speech-Language Pathologist PastSince Sep 1, 2019 Accepting new patients
Haaksma Speech Pathology Inc Speech-Language Pathologist PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 3

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1285857227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19501 MISTY RIDGE LN",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926791602",
            "telephone_number": "616-745-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19501 MISTY RIDGE LN",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926791602",
            "telephone_number": "616-745-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKSMA",
        "first_name": "BRENDA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "01109430",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "33135",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0000730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99556502",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trabuco Canyon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.