Kelly Marie Peetz, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

20327 Issued in CA

Practice address

3524 Torrance Blvd Ste 104
Torrance, CA 90503-4821

Phone

(310) 540-1630

NPI assigned

Apr 3, 2013

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pantea Sharifi Hannauer, M.D. Inc.

  • Pediatric Neurodevelopmental Disabilities Physician
  • Torrance, CA
  • NPI 1528332905
  NPD (past)
• Pediatric Minds Developmental Services, Inc.

  dba Pediatric Minds Developmental Services

  • Behavior Analyst
  • Torrance, CA
  • NPI 1376803742
  NPD (past)

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1457694812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 VAN HORNE LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784736",
            "telephone_number": "513-675-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 TORRANCE BLVD STE 104",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034821",
            "telephone_number": "310-540-1630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 W 213th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905012800",
            "country_code": "US",
            "telephone_number": "310-328-0276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEETZ",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Therapy Network
• Esther Banh Pedicini, MD
• Ryan Anthony Pedigo, M.D.
• Julia Pedri
• Deandra Pedroza
• Joan Peightal
• Darcey Mehrban Peindl
• Bryant Pelaez
• Daniel Pelayo
• Crystal Hustad Pena, APRN, NP-C

• Speech-Language Pathologist in Torrance, CA
• Providers in Torrance, 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 Mar 10, 2022; 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.