Jillian Hazel Rivaldi

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15192 Issued in CA

Practice address

1111 W 6TH St
Suite 111
Los Angeles, CA 90017-1800

Phone

(323) 404-1027

NPI assigned

Jun 1, 2010

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

Other names 1

• Jillian Hazel Poser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1396065355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE",
            "address_2": "SUITE 200",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302630",
            "telephone_number": "323-341-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 6TH ST",
            "address_2": "SUITE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171800",
            "telephone_number": "323-404-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVALDI",
        "first_name": "JILLIAN",
        "middle_name": "HAZEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "15192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "POSER",
            "middle_name": "HAZEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Los Angeles, CA
• Providers in Los Angeles, 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 Jun 1, 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.