NPIMap

Organization Active NPI

Mazda Speech-Language-Development Center

  • Speech-Language Pathologist
  • Valencia, CA
National Provider Identifier
1720339815
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-15203 Issued in CA
Legal business name
MAZDA SPEECH-LANGUAGE-DEVELOPMENT CENTER
Practice address
23734 Valencia Blvd.
Suite 304
Valencia, CA 91355
Phone
(661) 481-0872
Fax
(661) 481-0723
NPI assigned
Sep 28, 2012
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Ms. Perveen M. Katrack, CCC-SLPNPI 1992056154
Title
Owner
Phone
(661) 481-0872

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-15203 CA Primary
Early Intervention Provider Agency 252Y00000X 15203 CA

Addresses

Primary practice location

23734 Valencia Blvd.
Suite 304
Valencia, CA 91355

Mailing address

23734 Valencia Blvd.
Suite 304
Valencia, CA 91355
Phone (661) 481-0872

Other names 1

  • Mazda Infant-Toddler Development Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Mazda Infant-Toddler Development Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23734 Valencia Blvd
Ste 304
Valencia, CA 91355
Phone (661) 481-0872

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1720339815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23734 VALENCIA BLVD.",
            "address_2": "SUITE 304",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-481-0872",
            "fax_number": "661-481-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23734 VALENCIA BLVD.",
            "address_2": "SUITE 304",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-481-0872",
            "fax_number": "661-481-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZDA SPEECH-LANGUAGE-DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "KATRACK",
        "authorized_official_first_name": "PERVEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-481-0872",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP-15203",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "CA",
            "license": "15203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mazda Infant-Toddler Development Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.