Nina Dallal

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

28444 Issued in CA

Practice address

1659 Wellesley Ave
Los Angeles, CA 90025-3631

Phone

(310) 775-7664

NPI assigned

Dec 11, 2019

Last updated

Dec 8, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  dba Target Clinic Medical Associates of Southern California

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1023425972
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1710525571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 WELLESLEY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 WELLESLEY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253631",
            "telephone_number": "310-775-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9655 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913433307",
            "country_code": "US",
            "telephone_number": "818-892-8665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLAL",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2021-12-08",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "28444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Daley, PH.D.
• Shayna Daley
• Timothy Daley, RN
• Bethany Rene Dalger, NP
• Marla Marie Dallal
• Jonathan Dallas, MD
• Julie Ann Dalmau, NP
• Jose Ricardo Dalprat, D.O.
• Olya Dalrymple
• Barbara Dalton-Taylor, PH.D.

• Speech-Language Pathologist in Los Angeles, CA
• Providers in Los Angeles, 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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.