Individual provider Active NPI

Keisha Omwanghe, M.C.D.,CCC-SLP

  • Speech-Language Pathologist
  • Moreno Valley, CA
National Provider Identifier
1639724776
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
38218 Issued in CA
Practice address
22550 Town Cir
Moreno Valley, CA 92553-7502
Phone
(909) 951-5951
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 38218 CA Primary

Addresses

Primary practice location

22550 Town Cir
Moreno Valley, CA 92553-7502

Mailing address

10260 Prospector LN
Moreno Valley, CA 92557-4238
Phone (909) 495-6146

Other names 1

  • Keisha Jones Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
38218CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Omw Speech Pathology Services Speech-Language Pathologist Current Accepting new patients
High Desert Speech PastSince Aug 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1639724776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 PROSPECTOR LN",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925574238",
            "telephone_number": "909-495-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22550 TOWN CIR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537502",
            "telephone_number": "909-951-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMWANGHE",
        "first_name": "KEISHA",
        "credential": "M.C.D.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "38218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHA",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.