Individual provider Active NPI

Joelle Khristen Beach, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Trabuco Canyon, CA
National Provider Identifier
1487911632
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 13226 Issued in CA
Practice address
40 Gingham St
Trabuco Canyon, CA 92679-5340
Phone
(949) 291-0575
Fax
(949) 916-9242
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 13226 CA Primary

Addresses

Primary practice location

40 Gingham St
Trabuco Canyon, CA 92679-5340

Mailing address

40 Gingham St
Trabuco Canyon, CA 92679-5340
Phone (949) 291-0575

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP 13226CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
T for Talk 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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1487911632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GINGHAM ST",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926795340",
            "telephone_number": "949-291-0575",
            "fax_number": "949-916-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GINGHAM ST",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926795340",
            "telephone_number": "949-291-0575",
            "fax_number": "949-916-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "JOELLE",
        "middle_name": "KHRISTEN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 13226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trabuco Canyon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.