Brandon Clark, SLPA

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SPA5014 Issued in CA

Practice address

14369 Park Ave Ste 201a
Victorville, CA 92392-2300

Phone

(760) 278-1484

NPI assigned

Aug 4, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Momentum Speech Therapy Inc

  • Speech-Language Pathologist
  • Victorville, CA
  • NPI 1134701048
  NPD

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1619851615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 MANCHESTER CT",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925826903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14369 PARK AVE STE 201A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922300",
            "telephone_number": "760-278-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRANDON",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "SPA5014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norella Nicole Cisneros
• Citrus Counseling Services, Inc
• City Taxi
• Claremont Villa, Inc.
• Clarity Nursing, PC
• Donna Clark
• Shawnice Luetricia Clark
• Taryn Clark
• Tiffany Clark
• Tori Clark

• Speech-Language Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.