Active NPI
Olivia Myers
- Speech-Language Pathologist
- Gardena, CA
National Provider Identifier
1477071918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 32411
- Practice address
- 1045 W Redondo Beach Blvd Ste 135
Gardena, CA 90247-4104 - Phone
- (310) 553-2695
- NPI assigned
- Sep 5, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 3162 | CA | |
| Speech-Language Pathologist | 235Z00000X | 32411 | CA | Primary |
Addresses
Primary practice location
1045 W Redondo Beach Blvd Ste 135
Gardena, CA 90247-4104
Mailing address
26109 Frampton Ave Apt a
Harbor City, CA 90710-3466
Phone (209) 556-7582
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 |
|---|---|---|---|
| 32411 | CA | MD | Clinical Neuropsychologist |
| 3162 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Defining Voice | Speech-Language Pathologist | 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.
-
- Speech-Language Pathologist
- San Jose, CA
- NPI 1629445739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645660800000",
"number": "1477071918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26109 FRAMPTON AVE APT A",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907103466",
"telephone_number": "209-556-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 W REDONDO BEACH BLVD STE 135",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474104",
"telephone_number": "310-553-2695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "OLIVIA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2022-02-24",
"certification_date": "2022-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "3162",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "32411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.