Laurie Michelle Bohannon, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

11950 Issued in CA

Practice address

33854 Abbey Rd
Temecula, CA 92592-5607

Phone

(909) 964-8086

NPI assigned

Dec 20, 2013

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1699196402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33854 ABBEY RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925607",
            "telephone_number": "909-964-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33854 ABBEY RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925607",
            "telephone_number": "909-964-8086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41951 Moraga Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925914742",
            "country_code": "US",
            "telephone_number": "951-695-7130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "LAURIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-20",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "11950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Blum
• Brandyn Fredrick Bobb, MD
• Josephine Bogdon
• Laurence Henry Boggeln, M. D.
• Anto Boghokian, DO
• Darion Bokelman
• Tara Shawn Boland, BEHAVIOR ANALYST
• Amelia Bolaris
• Jennifer Bolden, ASW
• Jessica Bolet, LPCC, PPS

• Speech-Language Pathologist in Temecula, CA
• Providers in Temecula, 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 23, 2020; 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.