Emily Ruth Larsen, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

23665 Issued in CA

Practice address

22365 Barton Rd Ste 104
Grand Terrace, CA 92313-5037

Phone

(909) 824-2899

NPI assigned

Mar 13, 2018

Last updated

Mar 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Five Oaks Speech Therapy Services PC

  • Hearing and Speech Clinic/Center
  • Grand Terrace, CA
  • NPI 1770948283
  NPD (past)

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1386147650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25342 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543689",
            "telephone_number": "701-269-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22365 BARTON RD STE 104",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135037",
            "telephone_number": "909-824-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "EMILY",
        "middle_name": "RUTH",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "23665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Patrick Keough, D.C.
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• Myungjin Kim, P.T.
• Cassidy Carina Liu Koo
• Michael Anthony Lauw, PHARMD
• Matthew Lawantoro
• Sydney Layvas
• Lindy M Legoh
• Kaitlyn Leon

• Speech-Language Pathologist in Grand Terrace, CA
• Providers in Grand Terrace, 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 Mar 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.

Verify at the official NPI Registry.