Active NPI
Adeena Homampour
- Speech-Language Pathologist
- Costa Mesa, CA
National Provider Identifier
1447746482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP19128
- Practice address
- 2845 Mesa Verde Dr E Ste 9
Costa Mesa, CA 92626-4858 - Phone
- (714) 697-1907
- Fax
- (714) 464-4555
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- No
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 | SP19128 | CA | Primary |
Addresses
Primary practice location
2845 Mesa Verde Dr E Ste 9
Costa Mesa, CA 92626-4858
Mailing address
18685 Main St Ste 101-459
Huntington Beach, CA 92648-1723
Phone (949) 333-9914
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP19128 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Behavioral Health, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Huntington Beach, CA
- NPI 1518405166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1447746482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18685 MAIN ST STE 101-459",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926481723",
"telephone_number": "949-333-9914",
"fax_number": "714-464-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 MESA VERDE DR E STE 9",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264858",
"telephone_number": "714-697-1907",
"fax_number": "714-464-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMAMPOUR",
"first_name": "ADEENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-02",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP19128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.