Ilyssa T Abaranok, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15492 Issued in CA

Practice address

11215 Huston St
Suite 103
North Hollywood, CA 91601-5385

Phone

(310) 435-7920

Fax

(818) 358-3842

NPI assigned

Sep 1, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1699082362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 HUSTON ST",
            "address_2": "SUITE 103",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916015385",
            "telephone_number": "310-435-7920",
            "fax_number": "818-358-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 HUSTON ST",
            "address_2": "SUITE 103",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916015385",
            "telephone_number": "310-435-7920",
            "fax_number": "818-358-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABARANOK",
        "first_name": "ILYSSA",
        "middle_name": "T",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "15492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.