Raven Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

RAVEN SPEECH THERAPY

Practice address

21733 Vista Rd
Cedarpines Park, CA 92322-9232

Phone

(714) 588-3637

NPI assigned

Apr 7, 2021

Last updated

Apr 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marcoa Maisha Brownlee, MA CCC-SLP

Title

Ceo/Owner

Phone

(714) 588-3637

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1457930216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9124",
            "city": "CEDARPINES PARK",
            "state": "CA",
            "postal_code": "923229124",
            "telephone_number": "714-588-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21733 VISTA RD",
            "city": "CEDARPINES PARK",
            "state": "CA",
            "postal_code": "923229232",
            "telephone_number": "714-588-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "BROWNLEE",
        "authorized_official_first_name": "MARCOA",
        "authorized_official_middle_name": "MAISHA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "714-588-3637",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Rachele Bacquet
• Strengths Based Family Therapy

• Speech-Language Pathologist in Cedarpines Park, CA
• Providers in Cedarpines Park, 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 Apr 7, 2021; 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.