Active NPI
Jennifer E Peragine, M.S., CCC-SLP
- Speech-Language Pathologist
- Santa Monica, CA
National Provider Identifier
1407991904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17626
- Practice address
- 1754 9TH St
Apt D
Santa Monica, CA 90404-4388 - Phone
- (310) 463-5809
- NPI assigned
- Feb 21, 2007
- 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 Pathologist | 235Z00000X | 17626 | CA | Primary |
Addresses
Primary practice location
1754 9TH St
Apt D
Santa Monica, CA 90404-4388
Mailing address
1754 9TH St
Apt D
Santa Monica, CA 90404-4388
Phone (310) 463-5809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891930500 | Medicaid | FL |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17626 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367712000000",
"number": "1407991904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1754 9TH ST",
"address_2": "APT D",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904044388",
"telephone_number": "310-463-5809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1754 9TH ST",
"address_2": "APT D",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904044388",
"telephone_number": "310-463-5809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERAGINE",
"first_name": "JENNIFER",
"middle_name": "E",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2013-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "17626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891930500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.