Individual provider Active NPI

Robert Scott Davidson

  • Speech-Language Pathologist
  • Los Angeles, CA
National Provider Identifier
1376262352
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
36068 Issued in CA
Practice address
11980 San Vicente Blvd Ste 805
Los Angeles, CA 90049-6606
Phone
(202) 412-7644
NPI assigned
Aug 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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 36068 CA Primary

Addresses

Primary practice location

11980 San Vicente Blvd Ste 805
Los Angeles, CA 90049-6606

Mailing address

3868 S Centinela Ave Apt 18
Los Angeles, CA 90066-4459
Phone (202) 412-7644

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
COND.20222163-SPOHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Center for Developmental Enrichment Speech-Language Pathologist PastSince Aug 28, 2022 Accepting new patients
Literacy & Speech-Language Pathology Corporation Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1376262352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 S CENTINELA AVE APT 18",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664459",
            "telephone_number": "202-412-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 805",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496606",
            "telephone_number": "202-412-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "36068",
            "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 Aug 4, 2026; 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.