Emily Fortner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

20029 Issued in CA

Practice address

1058 Redwood Hwy Frontage Rd
Mill Valley, CA 94941-1621

Phone

(415) 924-2444

NPI assigned

Nov 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Dba Child Development Center of Marin

  • Hearing and Speech Clinic/Center
  • Mill Valley, CA
  • NPI 1780441949
  NPD

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1295559771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4487 SUNNYHILL ST",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913625112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 REDWOOD HWY FRONTAGE RD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411621",
            "telephone_number": "415-924-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jai Flicker
• Laravic Trance Flores, M.D.
• Tracy Elizabeth Foose, M.D.
• Denise Genevieve Santos Ford, CCC - SLP
• Patrick Ford, LMFT
• Michael David Fox, MD
• Tiffany Franco, DPT
• Karena Franses, LCSW
• Gerald C. Freedman, M.D.
• Conde C Freeman, LAC

• Speech-Language Pathologist in Mill Valley, CA
• Providers in Mill Valley, 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 Nov 12, 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.