Active NPI
Kassandra Priego
- Speech-Language Pathologist
- Justin, TX
National Provider Identifier
1700610862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 122868
- Practice address
- 17516 Matany Rd Ste 100
Justin, TX 76247-8707 - Phone
- (714) 904-2003
- NPI assigned
- Aug 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 122868 | TX | Primary |
Addresses
Primary practice location
17516 Matany Rd Ste 100
Justin, TX 76247-8707
Mailing address
17516 Matany Rd Ste 100
Justin, TX 76247-8707
Phone (714) 904-2003
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
| License | State | Type | Specialty |
|---|---|---|---|
| 122868 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755648000000",
"number": "1700610862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17516 MATANY RD STE 100",
"city": "JUSTIN",
"state": "TX",
"postal_code": "762478707",
"telephone_number": "714-904-2003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17516 MATANY RD STE 100",
"city": "JUSTIN",
"state": "TX",
"postal_code": "762478707",
"telephone_number": "714-904-2003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIEGO",
"first_name": "KASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-29",
"last_updated": "2025-08-20",
"certification_date": "2025-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "122868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Justin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.