Organization Active NPI

Mi Sueno Speech Therapy, Inc.

  • Speech-Language Pathologist
  • Covina, CA
National Provider Identifier
1306088299
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15105 Issued in CA
Legal business name
MI SUENO SPEECH THERAPY, INC.
Practice address
203 E Badillo St
Covina, CA 91723-2116
Phone
(626) 732-1111
Fax
(626) 732-1112
NPI assigned
Mar 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Norma A Lopez-Rivera, MSNPI 1689818833
Title
President/Ms CCC-SLP
Phone
(626) 732-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 15105 CA Primary

Addresses

Primary practice location

203 E Badillo St
Covina, CA 91723-2116

Mailing address

203 E Badillo St
Covina, CA 91723-2116
Phone (626) 732-1111

Other identifiers 1

IdentifierTypeStateIssuer
1306088299MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@misuenospeech.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210326001096 CA Part B Supplier - Clinic/Group Practice 1355758947 Receives reassigned benefits from 1 practitioner
Practice locations: Covina, CA

National Provider Directory

National Provider Directory

Locations

292 E Foothill Blvd
Ste A
Arcadia, CA 91006
Phone (626) 358-8488

500 E Olive Ave
Ste 320
Burbank, CA 91501
Phone (818) 239-5646

114 N 2nd Ave
Covina, CA 91723
Phone (626) 732-1111

203 E Badillo St
Covina, CA 91723
Phone (626) 732-1111

1936 Huntington Dr
Ste D
South Pasadena, CA 91030
Phone (626) 460-6320

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1306088299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232116",
            "telephone_number": "626-732-1111",
            "fax_number": "626-732-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232116",
            "telephone_number": "626-732-1111",
            "fax_number": "626-732-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI SUENO SPEECH THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-RIVERA",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/MS CCC-SLP",
        "authorized_official_telephone_number": "626-732-1111",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "15105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306088299",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@misuenospeech.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "203 E Badillo St",
            "city": "Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917232116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.