Paravee Prakongsup

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP29226 Issued in CA

Practice address

15928 Ventura Blvd Ste 218
Encino, CA 91436-4413

Phone

(818) 518-9709

NPI assigned

Feb 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Williams Speech Therapy Services Inc.

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1740637834
  NPD
• Novum Therapy Partners, Inc.

  • Speech-Language Pathologist
  • San Antonio, TX
  • NPI 1194588111
  NPD (past)

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

{
    "created_epoch": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1659837441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 WOODMAN AVE APT 114",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914027509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15928 VENTURA BLVD STE 218",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364413",
            "telephone_number": "818-518-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKONGSUP",
        "first_name": "PARAVEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "RPE13106",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP29226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pouyan & Khanideh Dental Corporation
• Pouyan Famini, M.D., a Medical Corporation
• Mehra Pouyan, D.D.S.
• Andranae Darnae Powns
• John-Paul Agustin Prakash, BCBA
• Natalie Celeste Preciado
• Preferred Home Health Care Inc.
• Premier Digestive Health a Medical Corporation
• Premier Physician Network
• Premium Podiatry, Inc.

• Speech-Language Pathologist in Encino, CA
• Providers in Encino, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.