Active NPI
Laura Vaughan Angelova, M.A., CCC-SLP
- Speech-Language Pathologist
- Chula Vista, CA
National Provider Identifier
1295144772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 20997
- Practice address
- 690 Otay Lakes Rd
Chula Vista, CA 91910 - Phone
- (619) 475-6910
- NPI assigned
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- No
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 | SP 20997 | CA | Primary |
Addresses
Primary practice location
690 Otay Lakes Rd
Chula Vista, CA 91910
Mailing address
12522 Montellano Ter
San Diego, CA 92130
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP 20997 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416441600000",
"number": "1295144772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12522 MONTELLANO TER",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 OTAY LAKES RD",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "91910",
"telephone_number": "619-475-6910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGELOVA",
"first_name": "LAURA",
"middle_name": "VAUGHAN",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-08",
"last_updated": "2014-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 20997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.