Individual provider Active NPI

Phyllis Herring, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Fountain Valley, CA
National Provider Identifier
1720147234
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP3291 Issued in CA
Practice address
10221 Slater Ave
Suite 115
Fountain Valley, CA 92708-4748
Phone
(949) 599-0218
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SP3291 CA Primary

Addresses

Primary practice location

10221 Slater Ave
Suite 115
Fountain Valley, CA 92708-4748

Mailing address

37 Highland VW
Irvine, CA 92603-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130322000271 CA Practitioner - Qualified Speech Language Pathologist 4183869100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP3291CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital of Orange County CurrentSince Jul 19, 2022 Accepting new patients
Newport Language and Speech Centers Speech-Language Pathologist Past Accepting new patients
Providence Speech and Hearing Center Speech-Language Pathologist Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients

Locations

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Organizations & group practices 4

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720147234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 HIGHLAND VW",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926033704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10221 SLATER AVE",
            "address_2": "SUITE 115",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084748",
            "telephone_number": "949-599-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRING",
        "first_name": "PHYLLIS",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP3291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.