Active NPI
Joann So
- Speech-Language Assistant
- Mesa, AZ
National Provider Identifier
1386131597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA11085
- Practice address
- 4309 E Florian Ave
Mesa, AZ 85206-2798 - Phone
- (909) 380-4779
- NPI assigned
- Apr 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA11085 | AZ | Primary |
Addresses
Primary practice location
4309 E Florian Ave
Mesa, AZ 85206-2798
Mailing address
26011 Reynolds St
Loma Linda, CA 92354-3941
Phone (909) 380-4779
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA11085 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523577600000",
"number": "1386131597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26011 REYNOLDS ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543941",
"telephone_number": "909-380-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4309 E FLORIAN AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852062798",
"telephone_number": "909-380-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SO",
"first_name": "JOANN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-13",
"last_updated": "2018-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA11085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.