Kimberly L Mantong, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP13077 Issued in CA

Practice address

41689 Enterprise Cir N
Suite 118
Temecula, CA 92590-5630

Phone

(951) 461-0615

Fax

(951) 296-1943

NPI assigned

Sep 9, 2011

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

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 and National Provider Directory roles.

• Nichols Speech Pathology and Therapy Services, Inc.

  • Speech-Language Pathologist
  • Temecula, CA
  • NPI 1093034779
  NPD (past)

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1376825968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BEGLEY DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817239",
            "telephone_number": "951-738-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41689 ENTERPRISE CIR N",
            "address_2": "SUITE 118",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905630",
            "telephone_number": "951-461-0615",
            "fax_number": "951-296-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTONG",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP13077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manmeet Singh Padda MD a Professional Corporation
• Ravinder Kaur Mann
• Laquita Keon Manning
• Sherry Aziz Manoly
• Danielle Mantione, O.D.
• Doris Manu
• Jean Mao, MFT
• Jennifer T Mao, OD
• Francheska Tinawin Mapanoo
• Basil Jawaid Maqbool, PHARM-D

• Speech-Language Pathologist in Temecula, CA
• Providers in Temecula, 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 Sep 9, 2011; 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.