Speech Language Pathology

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

SP 3165 Issued in CA

Legal business name

SPEECH LANGUAGE PATHOLOGY

Practice address

12791 Newport Ave
Suite 101
Tustin, CA 92780-2751

Phone

(714) 544-1860

Fax

(714) 730-5372

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Christine Switzer, MA

Title

Owner, Speech Pathologist

Phone

(714) 544-1860

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1639396286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE",
            "address_2": "SUITE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802751",
            "telephone_number": "714-544-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE",
            "address_2": "SUITE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802751",
            "telephone_number": "714-544-1860",
            "fax_number": "714-730-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH LANGUAGE PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "SWITZER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER, SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "714-544-1860",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "CA",
            "license": "SP 3165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0031650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "SP31650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Tustin, CA
• Providers in Tustin, CA by specialty
• Early Intervention Provider Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.