Active NPI
Michele Jean San Antonio, M.S. CCC-SLP
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1629520192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 13836
- Practice address
- 333 S Beaudry Ave
Los Angeles, CA 90017-1466 - Phone
- (213) 241-6200
- NPI assigned
- Oct 31, 2016
- Sex
- Female
- Sole proprietor
- No
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 | SP 13836 | CA | Primary |
Addresses
Primary practice location
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Mailing address
4334 Matilija Ave Apt 220
Sherman Oaks, CA 91423-3625
Phone (401) 269-9410
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 13836 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinity Professional Services 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.
-
- Speech-Language Pathologist
- Valley Village, CA
- NPI 1184081135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780358400000",
"number": "1629520192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4334 MATILIJA AVE APT 220",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914233625",
"telephone_number": "401-269-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 S BEAUDRY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171466",
"telephone_number": "213-241-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN ANTONIO",
"first_name": "MICHELE",
"middle_name": "JEAN",
"name_prefix": "Miss",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-31",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 13836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.