Individual provider Active NPI

Anna Weber, CCC-SLP

  • Speech-Language Pathologist
  • Redondo Beach, CA
National Provider Identifier
1528504289
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP12298 Issued in CA
Practice address
2850 Artesia Blvd Ste 107
Redondo Beach, CA 90278-3412
Phone
(424) 275-9968
Fax
(424) 383-1285
NPI assigned
Jan 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 SP12298 CA Primary

Addresses

Primary practice location

2850 Artesia Blvd Ste 107
Redondo Beach, CA 90278-3412

Mailing address

2850 Artesia Blvd Ste 107
Redondo Beach, CA 90278-3412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170922001570 CA Practitioner - Qualified Speech Language Pathologist 5092087130 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP12298CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speechcom Children's Speech Therapy Center, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Words and Motion Speech Therapy Group, Inc. Speech-Language Pathologist PastSince May 31, 2019 Accepting new patients

Locations

2850 Artesia Blvd
Ste 107
Redondo Beach, CA 90278
Phone (424) 275-9968

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1528504289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 ARTESIA BLVD STE 107",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 ARTESIA BLVD STE 107",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783412",
            "telephone_number": "424-275-9968",
            "fax_number": "424-383-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "ANNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP12298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.