Individual provider Active NPI

Mariah Prentice

  • Speech-Language Assistant
  • West Covina, CA
National Provider Identifier
1629419981
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SPA 2300 Issued in CA
Practice address
410 E Merced Ave Ste E
West Covina, CA 91790-5058
Phone
(323) 426-6402
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SPA 2300 CA Primary

Addresses

Primary practice location

410 E Merced Ave Ste E
West Covina, CA 91790-5058

Mailing address

1080 S la Cienega Blvd Ste 208
Los Angeles, CA 90035-2680
Phone (323) 426-6402

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

LicenseStateTypeSpecialty
SPA 2300CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DV Therapy Inc. Speech-Language Assistant CurrentSince Mar 24, 2025 Accepting new patients
Intercare Therapy, Inc. PastSince Dec 8, 2024 Accepting new patients
Intercare Therapy Inc. Past Accepting new patients

Locations

208 Oak St
Bakersfield, CA 93304
Phone (323) 505-6985

1080 S La Cienega Blvd
Ste 208
Los Angeles, CA 90035
Phone (661) 213-9340

190 Sierra Ct
Ste B6
Palmdale, CA 93550
Phone (323) 462-6402

410 E Merced Ave
Ste D
West Covina, CA 91790
Phone (323) 505-6985

410 E Merced Ave
Ste E
West Covina, CA 91790
Phone (626) 664-2570

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1629419981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 S LA CIENEGA BLVD STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352680",
            "telephone_number": "323-426-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E MERCED AVE STE E",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917905058",
            "telephone_number": "323-426-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "SPA 2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.