Mia Malotte Leeper, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

27126 Issued in CA

Practice address

1770 24TH St
Oceano, CA 93445-9164

Phone

(805) 710-4634

NPI assigned

Aug 22, 2017

Last updated

Jun 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Cross Speech and Language Center

  • Speech-Language Pathologist
  • Lompoc, CA
  • NPI 1730377433
  NPD (past)

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1336665223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 24TH ST",
            "city": "OCEANO",
            "state": "CA",
            "postal_code": "934459164",
            "telephone_number": "805-710-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 24TH ST",
            "city": "OCEANO",
            "state": "CA",
            "postal_code": "934459164",
            "telephone_number": "805-710-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEPER",
        "first_name": "MIA",
        "middle_name": "MALOTTE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "27126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nubia Daguia, F.N.P.
• Rebecca P Duffy
• Ethan Roy Etnyre, MD
• Brandy Nicole Fowler, M.ED., BCBA
• Juliet Iannoli-Ballard
• Victoria Tafoya Lowrie, VICTORIA LOWRIE MTBC
• Lucia Mar Unified School District
• Matthew Marron, RCS
• Karen S Mikuni, MD
• Kristyn Lauren Moore, RN

• Speech-Language Pathologist in Oceano, CA
• Providers in Oceano, 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 Jun 30, 2024; 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.