Venugopal Malligere Basavaraju, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18729 Issued in CA

Practice address

10801 Lindley Ave
Granada Hills, CA 91344-4441

Phone

(818) 275-4700

NPI assigned

May 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1679312722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 TAMPA AVE UNIT 183",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913261404",
            "telephone_number": "818-730-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 LINDLEY AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444441",
            "telephone_number": "818-275-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11601 Tampa Ave Unit 183",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913261404",
            "country_code": "US",
            "telephone_number": "818-730-6870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIGERE BASAVARAJU",
        "first_name": "VENUGOPAL",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nita C. Mahajan I, MD
• Priyanka Perin Mahajan, M.S.
• Mahendra N. Patel, M.D., Inc.
• Maher Nakoud D.D.S., Inc. (Knollwood Dental)
• Svitlana Malis, MSW, LCSW
• Kyle Matthew Maloney, DDS
• Leonardo Mangilit, RN
• Alisha Renee Manning
• Michelle Marie Manning, M.A., M.F.T.I,
• Armine T Manokian

• Speech-Language Pathologist in Granada Hills, CA
• Providers in Granada Hills, 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 May 20, 2024; 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.