Individual provider Active NPI

Alexandra Tealani Carbullido

  • Speech-Language Pathologist
  • Garden Grove, CA
National Provider Identifier
1336818541
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
RPE20760 Issued in CA
Practice address
12062 Valley View St Ste 137
Garden Grove, CA 92845-1741
Phone
(714) 901-1518
Fax
(714) 901-1359
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 RPE20760 CA Primary

Addresses

Primary practice location

12062 Valley View St Ste 137
Garden Grove, CA 92845-1741

Mailing address

12062 Valley View St Ste 137
Garden Grove, CA 92845-1741
Phone (714) 901-1518

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

State licenses

LicenseStateTypeSpecialty
RPE20760CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1336818541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 137",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451741",
            "telephone_number": "714-901-1518",
            "fax_number": "714-901-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12062 VALLEY VIEW ST STE 137",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451741",
            "telephone_number": "714-901-1518",
            "fax_number": "714-901-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBULLIDO",
        "first_name": "ALEXANDRA",
        "middle_name": "TEALANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "RPE20760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.