Jacqueline Gibbons

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

5907 Issued in CA

Practice address

1906 Commercenter E Ste 206
San Bernardino, CA 92408-3424

Phone

(909) 567-2935

NPI assigned

Sep 21, 2022

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Strive Logopedics Center Corp

  • Hearing and Speech Clinic/Center
  • San Bernardino, CA
  • NPI 1457097230
  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1396468765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 COMMERCENTER E STE 206",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083424",
            "telephone_number": "909-567-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 COMMERCENTER E STE 206",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083424",
            "telephone_number": "909-567-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "5907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PAY",
            "identifier": "1457097230",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Remedly",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR , RCM and medical billing.",
            "address_1": "1906 Commercenter E Ste 206",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924083424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Imaan Ghazali, PA-C
• GHC Home Health, Inc.
• Sudeshna Ghosh, MD
• Abdullah Khan Ghoury, MD
• Carol Ghraizi
• Christopher Frank Gibson, M.D.
• Cynthia Gibson
• Kristen Gibson
• Kyla Gibson
• Casey Anne Gidcumb

• Speech-Language Assistant in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.