Active NPI
Carolina Andrea Guajardo Kraljevic, CCC-SLP
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1730401753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-16696
- Practice address
- 2160 W Adams Blvd
Los Angeles, CA 90018-2039 - Phone
- (213) 748-5481
- NPI assigned
- Feb 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-16696 | CA | Primary |
Addresses
Primary practice location
2160 W Adams Blvd
Los Angeles, CA 90018-2039
Mailing address
2160 W Adams Blvd
Los Angeles, CA 90018-2039
Phone (213) 748-5481
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-16696 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Tracy Clinic | Speech-Language Pathologist | Current | Accepting new patients |
Locations
2160 W Adams Blvd
Los Angeles, CA 90018
Phone (213) 748-5481
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 1
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": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683763200000",
"number": "1730401753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 W ADAMS BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900182039",
"telephone_number": "213-748-5481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 W ADAMS BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900182039",
"telephone_number": "213-748-5481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUAJARDO KRALJEVIC",
"first_name": "CAROLINA",
"middle_name": "ANDREA",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SLP-16696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.