Full Potential Speech Therapy Center, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FULL POTENTIAL SPEECH THERAPY CENTER, INC

Practice address

27393 Ynez Rd Ste 153
Temecula, CA 92591-4605

Phone

(951) 331-2154

NPI assigned

Mar 13, 2019

Last updated

Aug 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Gisonda, MS CCC SLPNPI 1578049094

Title

President

Phone

(949) 606-6487

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Gisonda

  • Speech-Language Pathologist
  • Temecula, CA
  • NPI 1578049094
  NPD Authorized official
• Wenna Kae Pasana Requieron, CCC-SLP

  • Speech-Language Pathologist
  • Temecula, CA
  • NPI 1255070140
  NPD

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1548729122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44881 TROTSDALE DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925874",
            "telephone_number": "951-331-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27393 YNEZ RD STE 153",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914605",
            "telephone_number": "951-331-2154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41690 Enterprise Cir N Ste 112",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925905617",
            "country_code": "US",
            "telephone_number": "951-395-4234",
            "fax_number": "951-296-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FULL POTENTIAL SPEECH THERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "GISONDA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-606-6487",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1578049094",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bianca Rae Fuentes
• Elizabeth Fuentes
• Jennifer Fuentes
• Vanessa Ruby Fuentes
• Roland Musngi Fuertez, M.D.
• Edwin Bernardo Gaa
• Erica Gabriel
• Nicholas Dillon Gabriel, BCBA
• Kyle Gaily
• Gaits to Healing

• Speech-Language Pathologist in Temecula, CA
• Providers in Temecula, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.