Southern California Allergy

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

SOUTHERN CALIFORNIA ALLERGY

Practice address

16542 Ventura Blvd Ste 400
Encino, CA 91436-5045

Phone

(818) 990-9155

Fax

(818) 990-9167

NPI assigned

Aug 19, 2011

Organization subpart

No

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

Authorized official

Name

Candice Kennon

Title

Practice MGR

Phone

(512) 732-2774

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danica Schulte, MD

  • Allergy & Immunology Physician
  • Encino, CA
  • NPI 1386645083
  Medicare reassignment NPD
• Henry Joseph Legere III, MD

  • Allergy Physician
  • Austin, TX
  • NPI 1669464723

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1730469974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MAIN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786645246",
            "telephone_number": "512-732-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16542 VENTURA BLVD STE 400",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365045",
            "telephone_number": "818-990-9155",
            "fax_number": "818-990-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA ALLERGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "KENNON",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "PRACTICE MGR",
        "authorized_official_telephone_number": "512-732-2774"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Pacific Rehabilitation
• South Pacific Sleep Lab, Inc.
• South Valley Regional Dialysis Center Inc
• South Valley Senior Care LLC
• Southern California Advanced Diagnostic
• Southern California Stone Center
• Southwest Hospice Care, Inc
• Maya Spamer, MS, BCBA
• Emma Jean Sparks
• Lanae Sparks

• Allergy & Immunology Physician in Encino, CA
• Providers in Encino, CA by specialty
• Allergy & Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.