Active NPI
Amanda Liebman
- Speech-Language Pathologist
- El Cajon, CA
National Provider Identifier
1568801348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 20761
- Practice address
- 260 E Chase Ave Ste 204
El Cajon, CA 92020-6300 - Phone
- (619) 647-6157
- NPI assigned
- Jun 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 20761 | NY | Primary |
Addresses
Primary practice location
260 E Chase Ave Ste 204
El Cajon, CA 92020-6300
Mailing address
449 Nautilus St
La Jolla, CA 92037-5968
Other practice location 1
811 Agate St
unit 1
San Diego, CA 92109-1190
Phone (631) 402-2881
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 |
|---|---|---|---|
| 20761 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smalltalk Speech and Occupational Therapies, Inc | 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.
-
- Rehabilitation Clinic/Center
- La Mesa, CA
- NPI 1619298791
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613606400000",
"number": "1568801348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "449 NAUTILUS ST",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920375968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 E CHASE AVE STE 204",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920206300",
"telephone_number": "619-647-6157"
}
],
"practiceLocations": [
{
"address_1": "811 Agate St",
"address_2": "unit 1",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921091190",
"country_code": "US",
"telephone_number": "631-402-2881",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIEBMAN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-14",
"last_updated": "2021-02-18",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "20761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.