Individual provider Active NPI

Eric Nicsinger, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1326378142
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13306 Issued in CA
Practice address
629 Traction Ave Apt 112
Los Angeles, CA 90013-1680
Phone
(818) 723-9316
NPI assigned
Dec 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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 13306 CA Primary

Addresses

Primary practice location

629 Traction Ave Apt 112
Los Angeles, CA 90013-1680

Mailing address

629 Traction Ave Apt 112
Los Angeles, CA 90013-1680
Phone (818) 723-9316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
13306CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1326378142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 TRACTION AVE APT 112",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131680",
            "telephone_number": "818-723-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 TRACTION AVE APT 112",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131680",
            "telephone_number": "818-723-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICSINGER",
        "first_name": "ERIC",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.