Active NPI
Cassandra Johanson
- Speech-Language Pathologist
- Phoenix, AZ
National Provider Identifier
1487790218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLPL2188
- Practice address
- 20402 N, 15TH Ave
Phoenix, AZ 85027 - Phone
- (623) 445-5000
- NPI assigned
- Jan 29, 2007
- 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 | SLPL2188 | AZ | Primary |
Addresses
Primary practice location
20402 N, 15TH Ave
Phoenix, AZ 85027
Mailing address
4417 E Muriel Dr
Phoenix, AZ 85032-9257
Phone (602) 561-8079
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 |
|---|---|---|---|
| SLPL2188 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1487790218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4417 E MURIEL DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850329257",
"telephone_number": "602-561-8079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20402 N, 15TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85027",
"telephone_number": "623-445-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANSON",
"first_name": "CASSANDRA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLPL2188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.