Carrie Wada, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

25390 Issued in CA

Practice address

17842 Irvine Blvd Ste 118
Tustin, CA 92780-3243

Phone

(949) 903-8229

NPI assigned

Nov 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Zenith Speech Therapy Inc

  • Speech-Language Pathologist
  • Irvine, CA
  • NPI 1851841191
  NPD (past)

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669915815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 S LEXINGTON PL",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054935",
            "telephone_number": "714-586-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17842 IRVINE BLVD STE 118",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803243",
            "telephone_number": "949-903-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "CARRIE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "25390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLPAB",
            "identifier": "25390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelina Mai Hong Phuoc Vuong
• Louis Vuong, DC
• Tam CHI Vuong
• W. Robert Crumpton, M.D.
• W. Saraiva DDS, Inc.
• Mark Robert Wade, M.D.
• Nancy Ann Wahidi, PA
• Karen Toki Wakayama, OD
• Walgreen Co
• Leiza Yamila Walia, D.M.D.

• Speech-Language Pathologist in Tustin, CA
• Providers in Tustin, 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 Jul 21, 2022; 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.