Kerri Anne Staab, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

20282 Issued in CA

Practice address

343 6TH St
Unit L
Norco, CA 92860-1784

Phone

(951) 340-0431

NPI assigned

Jun 14, 2013

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

• Kerri Anne Grimes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Leaps and Bounds Pediatric Physical Therapy Inc

  • Physical Therapist
  • Norco, CA
  • NPI 1407174980

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1437598224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 CANYON VIEW PL",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 6TH ST",
            "address_2": "UNIT L",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601784",
            "telephone_number": "951-340-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "KERRI",
        "middle_name": "ANNE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "GRIMES",
            "middle_name": "ANNE",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Smith, RDN
• Malik Smith
• Sameh Nashat Soliman, DMD, MPH
• Adriana Castro Soriano, LCSW
• Southern California Emergency Medicine
• Starry Eyes Optometry, Inc.
• Ireneusz Jerzy Stasiuk, MSW
• Michael J. Stefano, D.C.
• Irene Marie Stetkevich, M.A., CCC-SLP
• Linden Gary Stevens, D.D.S.

• Speech-Language Pathologist in Norco, CA
• Providers in Norco, 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 14, 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.

Verify at the official NPI Registry.