Fundy M Pierre-Louis, CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

24829 Issued in CA

Practice address

12139 Mount Vernon Ave Ste 110
Grand Terrace, CA 92313-5500

Phone

(909) 883-5069

NPI assigned

Jan 25, 2017

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

State licenses

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306383534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12139 MT VERNON AVE",
            "address_2": "SUITE 110",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "92313",
            "telephone_number": "909-883-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12139 MOUNT VERNON AVE STE 110",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135500",
            "telephone_number": "909-883-5069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24670 University Ave",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542743",
            "country_code": "US",
            "telephone_number": "702-499-3833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERRE-LOUIS",
        "first_name": "FUNDY",
        "middle_name": "M",
        "credential": "CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Grand Terrace, CA
• Providers in Grand Terrace, 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 Jul 21, 2022; 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.