Individual provider Active NPI

Monica L. Avina-Vizzerra, M.S.

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1306153028
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP6853 Issued in AZ
Practice address
3401 N 67TH Ave
Phoenix, AZ 85033-4517
Phone
(623) 691-4085
NPI assigned
Sep 1, 2010
Last updated
Sep 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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 TSLP6853 AZ Primary

Addresses

Primary practice location

3401 N 67TH Ave
Phoenix, AZ 85033-4517

Mailing address

368 Ancora Dr S
Litchfield Park, AZ 85340-4639
Phone (602) 770-3307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190831000284 AZ Practitioner - Qualified Speech Language Pathologist 5698004513 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TSLP6853AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Jun 18, 2019 Accepting new patients
Therapy Tree, PLLC Speech-Language Pathologist Past Accepting new patients
Therapy Tree Group PLLC PastSince Dec 13, 2022 Accepting new patients

Locations

21045 N 9th Pl
Ste 204
Phoenix, AZ 85024
Phone (480) 548-2601

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1306153028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 ANCORA DR S",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404639",
            "telephone_number": "602-770-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N 67TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850334517",
            "telephone_number": "623-691-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVINA-VIZZERRA",
        "first_name": "MONICA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP6853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.