NPIMap

Organization Active NPI

Bright Star

  • Speech-Language Pathologist
  • Tustin, CA
National Provider Identifier
1366730657
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 10738 Issued in CA
Legal business name
BRIGHT STAR
Practice address
17291 Irvine Blvd
Suite 325
Tustin, CA 92780-2941
Phone
(714) 730-7700
Fax
(714) 730-7766
NPI assigned
Jul 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Harry Ayala
Title
Executive Director
Phone
(714) 730-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP 10738 CA Primary

Addresses

Primary practice location

17291 Irvine Blvd
Suite 325
Tustin, CA 92780-2941

Mailing address

17291 Irvine Blvd
Suite 325
Tustin, CA 92780-2941
Phone (714) 730-7700

National Provider Directory

National Provider Directory
Tax ID family
Bright Star2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17291 Irvine Blvd
Ste 325
Tustin, CA 92780
Phone (714) 730-7700

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1366730657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17291 IRVINE BLVD",
            "address_2": "SUITE 325",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802941",
            "telephone_number": "714-730-7700",
            "fax_number": "714-730-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17291 IRVINE BLVD",
            "address_2": "SUITE 325",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802941",
            "telephone_number": "714-730-7700",
            "fax_number": "714-730-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT STAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-730-7700"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 10738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.