Tustin Speech Therapy, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17425 Issued in CA

Legal business name

TUSTIN SPEECH THERAPY, INC

Practice address

661 W 1St St Ste E
Tustin, CA 92780-2939

Phone

(714) 838-2853

NPI assigned

May 9, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Kymry Hart Fowler, MS-CCC

Title

Chief Executive Officer

Phone

(714) 838-2853

Specialties & licenses 5

Addresses

Other identifiers 1

Tax ID family

Tustin Speech Therapy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Tustin Speech Therapy Inc.

  • Rehabilitation Clinic/Center
  • Tustin, CA
  • NPI 1952712655
  NPD tax ID
• Tustin Speech Therapy, Inc

  • Hearing and Speech Clinic/Center
  • Tustin, CA
  • NPI 1235532599
  NPD tax ID
• Tustin Speech Therapy, Inc.

  • Speech-Language Pathologist
  • Tustin, CA
  • NPI 1437606555
  NPD tax ID

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1306257548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-838-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-838-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN SPEECH THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "KYMRY",
        "authorized_official_middle_name": "HART",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-838-2853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS-CCC"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "2634",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "722",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "722",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "655",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "17425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tustin Physical Therapy Specialists, Inc.
• Tustin Place Medical Group
• Tustin Podiatry Clinic Inc
• Tustin Speech Therapy Inc.
• Tustin Speech Therapy, Inc
• Tustin Speech Therapy, Inc.
• Tustin Teleradiology Medical Group Inc.
• Tustin Unified School District
• Tustin Urgent Care, Apc (Xpress Urgent Care Tustin)
• Ranko Savic Tutulugdzija, L.A.

• Speech-Language Pathologist in Tustin, CA
• Providers in Tustin, 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 May 9, 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.

Verify at the official NPI Registry.