Individual provider Active NPI

Izabel Anamaria Pena, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1710869870
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP17680 Issued in AZ
Practice address
4925 E Ingram St
Mesa, AZ 85205-3314
Phone
(480) 472-8500
NPI assigned
Jul 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 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 SLP17680 AZ Primary

Addresses

Primary practice location

4925 E Ingram St
Mesa, AZ 85205-3314

Mailing address

1025 N Country Club Dr
Mesa, AZ 85201-3307
Phone (480) 472-0500

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TSLP16542AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1710869870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013307",
            "telephone_number": "480-472-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 E INGRAM ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053314",
            "telephone_number": "480-472-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "IZABEL",
        "middle_name": "ANAMARIA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-21",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP17680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

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