Individual provider Active NPI

Demetra Korovessis

  • Speech-Language Pathologist
  • Rancho Cucamonga, CA
National Provider Identifier
1710824362
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
8880 Base Line Rd
Rancho Cucamonga, CA 91701-5504
Phone
(909) 989-5511
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

8880 Base Line Rd
Rancho Cucamonga, CA 91701-5504

Mailing address

8880 Base Line Rd
Rancho Cucamonga, CA 91701-5504

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

NPI Registry JSON

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

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1710824362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 BASE LINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 BASE LINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015504",
            "telephone_number": "909-989-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROVESSIS",
        "first_name": "DEMETRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.