Individual provider Active NPI

Elizabeth Wyche Stratton, M.S. CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1497153696
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
27786 Issued in CA
Practice address
2942 Kalmia St
San Diego, CA 92104-5415
Phone
(603) 909-7278
NPI assigned
Dec 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 510779B WA
Speech-Language Pathologist 235Z00000X 27786 CA Primary

Addresses

Primary practice location

2942 Kalmia St
San Diego, CA 92104-5415

Mailing address

5000 NE 72ND Ave Apt L75
Vancouver, WA 98661-8170
Phone (360) 909-7278

Other identifiers 1

IdentifierTypeStateIssuer
27786OtherCASTATE OF CALIFORNIA SLP LICENCE

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 Science

State licenses

LicenseStateTypeSpecialty
510779BWAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1419120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1497153696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 NE 72ND AVE APT L75",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986618170",
            "telephone_number": "360-909-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 KALMIA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045415",
            "telephone_number": "603-909-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATTON",
        "first_name": "ELIZABETH",
        "middle_name": "WYCHE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-21",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "510779B",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "27786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA SLP LICENCE",
            "identifier": "27786",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.