Individual provider Active NPI

Trisha Van Dillen, M.A. CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1417116096
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 15100 Issued in CA
Practice address
5764 Cornflower TRL
San Diego, CA 92130-6917
Phone
(858) 449-3303
NPI assigned
Jun 9, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 15100 CA Primary

Addresses

Primary practice location

5764 Cornflower TRL
San Diego, CA 92130-6917

Mailing address

5764 Cornflower TRL
San Diego, CA 92130-6917
Phone (858) 449-3303

Other names 1

  • Trisha Oergel Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
SP 15100CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1417116096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 CORNFLOWER TRL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306917",
            "telephone_number": "858-449-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 CORNFLOWER TRL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306917",
            "telephone_number": "858-449-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DILLEN",
        "first_name": "TRISHA",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 15100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISHA",
            "last_name": "OERGEL",
            "credential": "M.A. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.