Individual provider Active NPI

Carolynn Larner

  • Speech-Language Pathologist
  • Glendora, CA
National Provider Identifier
1366764458
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP4080 Issued in CA
Practice address
2605 East Foothill Blvd
Glendora, CA 91740
Phone
(626) 963-8080
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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 SP4080 CA Primary

Addresses

Primary practice location

2605 East Foothill Blvd
Glendora, CA 91740

Mailing address

2605 East Foothill Blvd
Glendora, CA 91740
Phone (626) 963-8080

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
SP4080CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Speech and Language Associates Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1366764458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 EAST FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91740",
            "telephone_number": "626-963-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 EAST FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91740",
            "telephone_number": "626-963-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARNER",
        "first_name": "CAROLYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP4080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.