Sandra Paek, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

24702 Issued in CA

Practice address

15506 S Normandie Ave
Gardena, CA 90247-4014

Phone

(909) 539-8722

NPI assigned

May 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1417447632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 LA TIJERA BLVD APT B101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15506 S NORMANDIE AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474014",
            "telephone_number": "909-539-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAEK",
        "first_name": "SANDRA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109049",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariana Abigail Padilla
• Matthew Jhonathan Padilla
• Mayerlin Escarlen Padilla
• Patrisia Padilla, CADC-CAS,C033490315
• Stephanie Victoria Padilla
• Gisselle Paez
• Sandra Paglinawan
• Carter Henry Paige, BA
• Kayla Alexis Paiz
• Shaina Pakravan

• Speech-Language Pathologist in Gardena, CA
• Providers in Gardena, 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 May 14, 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.