Individual provider Active NPI

Patricia Marie Carlton

  • Speech-Language Assistant
  • San Clemente, CA
National Provider Identifier
1700610763
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SPA4990 Issued in CA
Practice address
1031 Avenida Pico Ste 201
San Clemente, CA 92673-6356
Phone
(949) 388-8788
NPI assigned
Aug 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SPA4990 CA Primary

Addresses

Primary practice location

1031 Avenida Pico Ste 201
San Clemente, CA 92673-6356

Mailing address

86 Esencia Dr Unit 737
Rancho Mission Viejo, CA 92694-1322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SPA4990CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wee Thrive Pediatric Therapy Group PastSince Sep 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1700610763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 ESENCIA DR UNIT 737",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 AVENIDA PICO STE 201",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736356",
            "telephone_number": "949-388-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "SPA4990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.