Individual provider Active NPI

Khushbu Bhakta, B.A., SLPA

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1336547082
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
29496 Issued in CA
Practice address
2911 W Jefferson Blvd
Los Angeles, CA 90018-3340
Phone
(323) 839-4171
NPI assigned
Dec 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 3030 CA
Speech-Language Pathologist 235Z00000X 29496 CA Primary

Addresses

Primary practice location

2911 W Jefferson Blvd
Los Angeles, CA 90018-3340

Mailing address

2911 W Jefferson Blvd
Los Angeles, CA 90018-3340
Phone (323) 839-4171

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
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
29496CAMDSpeech-Language Pathologist
3030CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1336547082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 W JEFFERSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900183340",
            "telephone_number": "323-839-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 W JEFFERSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900183340",
            "telephone_number": "323-839-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "KHUSHBU",
        "credential": "B.A., SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "3030",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "29496",
            "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 Feb 25, 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.